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PS 604

Credit Card Non-Receipt Report (10/2006)

Download and Print the PS 604

Request may not be processed if the form is incomplete or illegible.

To: Postal Inspector in Charge
The below named addressee has advised us that he or she did not receive the credit card we mailed.

Keep Part 2. Send Part 1 to the Postal Inspector in Charge of the division in which your place of business is located. Find the location at Additional copies of this
form will be given to the Postal Inspector in Charge on request.

1a. Name of Addressee 1
1b. Street Address (No., street, apt./ste./PO box no.)
2b. Street Address (No., street, apt./ste./PO box no.)
1c. City 1d. State 1e. ZIP + 4® 2c. City 2d. State
f. Telephone Number (Include area code)

2a. Name of Mailer 2f. Telephone Number (Include area code)

3. Date Mailed

4. Mailed at (Location, city, state, ZIP + 4)

5a. Type of Card (American Express, Discover, MasterCard, Visa, etc.) 5b. Card Number 5c. Expiration Date

6. Where were purchases made? 7. Date Purchases Began (MM/DD/YYYY) 8. Total Amount of Purchase(s) $

9. Postal Inspector Use
PS Form 604, October 2006 PSN 7530-02-000-9430 1-Postal Inspector in Charge 2- Keep for Your Records

And much more...