| For Everyone |
| Box 1: | Enter date |
| Box 2: | Name in Which Applicant's Mail Will Be Received for Delivery to Agent. (Most of the cases your company name.) |
| Box 3: | Enter your mailing address provided by your mail forwarding service. |
| Box 4: | Enter the mailing address of your mail forwarding agent. |
| Box 5: | Enter 'Yes' and sign inside the box if you want the agent to accept registered mail for you |
| Box 6: | Enter your name |
| Box 7: | Enter your address and phone number |
| Box 8: | Enter the number of your 2 types of identification. Make copies of those identifications to send with your form. Please be sure to include expiration date of the IDs. |
| For Businesses |
| Box 9: | Enter your company name |
| Box 10: | Enter your company's address and phone number |
| Box 11: | Enter the type of business |
| Box 12: | For the business, enter the names of the people who will receive mail |
| Box 13: | Enter the names and addresses of the company officers |
| Box 14: | Enter the registered business name and address, plus the country, state and date of registration |
| For Everyone |
| Box 15: | Get the form signed by agent or notary public |
| Box 16: | Your signature |
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| Because the service is required to have the originals, send the completed form, along with the copies of your identification to your mail forwarding service. Lockers and Mailboxes 1201 North Vermont Avenue Los Angeles, CA 90029-1703, U.S.A. Please be sure to follow above instructions.
Download Form 1583 (PDF) |