Schedule Delivery Request Form

Delivery Name (on notice): *
File Number (on notice): *
Address where the notice was received? *
What is your relationship to the person listed on the delivery notice? *
If the person listed on the delivery notice is unknown, please list this is the additional details section below.
Does the person listed on the delivery notice live at the address where the notice was left? *
What Residence is this? *
Type the Name of the Current Resident in this field, if the person listed does not live here, we need to confirm who does (for security purposes) only. If the person listed is the resident, type "Your Name" here.
How long have you lived at the address where the delivery notice was left? *
What is the correct home address where we can redeilver to the person listed on the notice (list City, State & Zip Code). *
Type "SAME" if we should redeliver to the same address where the notice was left or type "UNKNOWN" if you do not know the person listed.
Provide any additional information you have for the person listed on the delivery notice (phone numbers, addresses, relatives, other) *
If you are the person on the delivery notice, type IT IS ME in this field.
What is the best DATE to redeliver at HOME? *
Type "UNKNOWN" if you do not know the person listed.
What is the best TIME to redeliver at HOME? *
Type "UNKNOWN" if you do not know the person listed.
If you would like for us to redeliver at your WORK address, please type that address here (City, State & Zip Code)? *
Type HOME if you prefer to receive the delivery at your home address or Type "UNKNOWN" if you do not know the person listed.
What is the best DATE to redeliver at WORK? *
Type HOME if you do not want us to redeliver at work address or Type "UNKNOWN" if you do not know the person listed.
What is the best TIME for us to redeliver at WORK?
Type HOME if you do not want us to redeliver at work address or Type "UNKNOWN" if you do not know the person listed.
What Phone Number can we contact you at for (verification) purposes? *
Type your contact phone number in this field (either way), if you do not know the person listed on the delivery notice, we may need to call you to confirm this information provided by you.
Drivers License Number (for security purposes) only *
Type the Drivers License Number in this field (either way) for security purposes only, if the person is unknown, please type your Drivers License Number to confirm your identity only.
Date of Birth *
Type the Date of Birth (either way) for security purposes only, if the person is unknown, please type your Date of Birth to confirm your identity only.
Additional Information: *
Type any additional information here or type NONE, if there is no additional information.
By Typing My Name, I am confirming that the information provided above is true to the best of my knowledge (type first & last name). *
Date Completed (type date): *
Email Address (for confirmation) only *