Fillable Printable USPS Address Change Form - Traditional
Fillable Printable USPS Address Change Form - Traditional
USPS Address Change Form - Traditional
National Customer Support Center
Address Change Service Application —
Traditional
Mail Classification Company Name Taxpayer ID
ACS Contact Information
Option 1
Option 2
Option 3
Option 4
Option 5
Option 6
See USPS
®
Publication 8-A, Address Change
Service — Traditional, for a complete description
of the Periodicals ACS notification options.
Publication 8-A can be found at:
http://www.usps.com/cpim/ftp/pubs/pub8A.pdf.
PS Form 3572, March 2006
Authorization
I hereby authorize the United States Postal Service
®
to provide change-of-address information for the
mailpiece title(s) listed, under the prescribed terms and conditions of the Address Change Service (ACS).
I understand the ACS is an electronic enhancement to and not a replacement of the traditional manual
address correction process. It is designed to reduce the volume of manual address corrections provided
on properly endorsed ACS mail.
Name (Please print clearly) Title
Signature Date Signed
Complete this application and mail or fax to:
ADDRESS CHANGE SERVICE DEPT
NATIONAL CUSTOMER SUPPORT CENTER
UNITED STATES POSTAL SERVICE
6060 PRIMACY PKWY STE 201
MEMPHIS TN 38188-0001
FAX: 901-821-6204
Voice:800-331-5746
ACS Shipping Information
ACS Billing Information
ACS Participant Information
Please enter the mailpiece title(s) for which you are requesting ACS participant codes. We will notify you
about the codes within 10 days of receipt of your application. Photocopy additional pages if necessary.
Mailpiece Title(s)
Shipper-Paid
Forwarding
(Standard Mail
and Package
Services)
ACS Participant Code
(USPS
®
use only)
Privacy Notice: For information regarding our Privacy Policy visit www.usps.com.
(Periodicals Only)
Web (Complete PS Form 1357-W, Web
Access Request)
CD-ROM (A)
CD-ROM (B)
Address Service Requested
Option1
Change Service Requested
Option 1
Option 2
Option 2
Schedule
Daily (Web only)
Bi-weekly
Weekly
Bi-monthly
Monthly
(Options apply to First-Class Mail
®
service only)
(Options apply to First-Class Mail
®
service only)
Fulfillment
File Options
Ancillary Service Endorsement
ACS Notification Option
With Keyline
(Y or N)
Keyline
Length
Attribute
(A - Alpha, N - Numeric, or
A/N - Alphanumeric)
Y
Y
Y
Y
Y
Y
Y
Y
N
N
N
N
N
N
N
N
N
N
N
N
A/N
A/N
A/N
A/N
A
A
A
A
Attention Line
Company Name
Street Address
City State
ZIP + 4
Telephone Number (Include area code)
Fax Number (Include area code)
Apt./Ste. Number
Attention Line
Company Name
Street Address
City State
ZIP + 4
Telephone Number (Include area code)
Fax Number (Include area code)
Apt./Ste. Number
Attention Line
Company Name
Street Address
City State
ZIP + 4
®
Telephone Number (Include area code)
Fax Number (Include area code)
Apt./Ste. Number
