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Application for Delivery of Mail Through Agent See Reverse for Instructions, Definitions, Agreement Terms, and the Privacy Act Statement. 1. Private Mailbox (PMB) Information 1a. Date PMB Opened1b.

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Read the instructions on the front of the document.

02

Turn the document over to the reverse side.

03

Follow the step-by-step instructions provided on the reverse side to complete the form.

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01

Anyone who is required to fill out the form mentioned on the front side and needs additional guidance on how to do so.

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See reverse for instructions refers to a directive that indicates important information or guidelines are provided on the reverse side of a document.

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