EFTA00097136.pdf

in ited States Postal Service pplication for Delivery of Mall Through Agent 1. Date ee Privacy Act Statement on Reverse 04/09/2018 consideration of delivery of my or our (firm) mail to the agent named below, the addressee and agent agree: ust not file a change of address order with the Postal Seri/lo (1) the addressee or the agent an, upon termination of the agency relationship; idress is the responsibility of the addressee and the agent; (2) the transfer of mail to another (3) all mail delivered to the agency under this pm postage when redeposited in the mails; (4) upon request the authorization must be prepaid with agent must provide to the Postal Service all 3nsfers mail; and (5) when any information required on addresses to which the agency this form changes or becomes obsolete, the addres ,plication with the Commercial Mall Receiving Agenc see(s) must file a revised y (CMRA). OTE: The applicant must execute this form in duplicate in the presence of the agent, his or her authorized ie agent provides the original completed signed PS employee, or a notary public Form 1583 to the Postal Service and retains a MRA business location. The CMRA copy of PS duplicate completed signed copy at the Form PS 1583 must at all times be available for examin 3cl the Postal Inspection Service. The addressee ation by the postmaster (or designee) and the agent agree td comply with all applicable delivery of mall through an agent. Failure to comply Postal Service rules and regulations relative will subject the agency to withholding of mail from delivery until corrective action is taken. fis application may be subject to verification proced ures by the Postal Service to confirm that the applica me or business address listed in boxes 7 or 10, and that nt resides or conducts business at the the identification listed in box 8 is valid. Name in Which Applicant's Mail Will Be Received for Deliver y to Omplete a separate PS Form 1583 for EACH applicant. Spouse Agent 3a.Address to be Used for Delivery (Include PMB or / sign.) s may implete and sign one PS Form 1583. Two items of valid identific ation ply to each spouse. Include dissimilar information for either spouse horopriate box.) in 3b. City fislaine maxwell 3c. State 3d. Zip + 4 Boston MA 02114 Applicant authorizes delivery to and in care of: 5. This authorization is extended to include res rioted undersigned(s): defivery mail for the Name le UPS Store #5788 Yes Address (No., street, apt./ste. no.) City d. State . Zip + 4 iston MA 02114 Name of Applicant L7a. Applicant Home Address (No., street, apt/ste. islaine maxwell *wo types of identification are required. One must contain a photog b. City 7c. State :he addressee(s). Social Security cards, credit cards, and birth raph 7d. bp +4 1ificates are unacceptable as identification. The agent must write boston MA 02114 in ntifying information. Subject to verification. Number (Include area code) 1IIM. .Name of Firm or Corporafion N/A Oa. Business Address (No., street, apt./ste. no.) N/A Ob. City 10c. State 10d. Zlp +4 :eatable identification includes: valid drivers license or state non-dri itification card; armed forces, government, university, or recogn ver's N/A ized N/A N/A ,orate identification card; passport, alien registration card or certificate Oe. Business Telephone Number (Include area code) aturalization; current lease, mortgage or Deed of Trust; voter or vehicle N/A stration card; or a home or vehicle insurance policy. A photocopy of r identification may be retained by agent for verification. 1. Type of Business N/A If applicant is a firm, name each member whose mail is to be delivered. res of minors receiving mail at their delivery address.) (All names listed must have verifiable identification. A guardian must list the If a CORPORATION. Give Names and Addresses of Its Officers 14. If business name (corporation or trade name) has been registered, give name of county and state, and date of registration. N/A N/A ning: The furnishing of false o misleading information on this form or imprisonment and/or civil sanctions (including multiple damages and omissio n of material information may result in criminal sanctions (includi civil enalties) ng fines 16. Signature of licant (If firm or corporation, application must be signed by officer. Show . -orm 1583 December 2004 (Page 1 of 2) (7530-01.000-9365) EFTA00097136  Mailbox Service Agreement Customer Information Center Number: 5768 Name: Company: kddilaSS: City: boston Stele: ; me j ZIP: 02114 Business Telephone: Home Telephone: Fax: Mobile Telephone: E-mail Text Messaging ID: MID Mailbox Information Mailbox Number Mailbox Size: Small rams and Conditions 1. This Mailbox Service Agreement ("Agreement" is made and services related to a mailbox Mailbox" at The UPS Stara/oentered kilo by the customer Identified above ("Customer) for the use of and r Mail Boxes Etc.® Center Identified above ('Center') herein. under the terms set forth 2. Customer agrees that Customer will not use the Center premise or for any purpose prohibited by U.S. postal regulations. Customs or any Center services for any unlawful. illegitimate, or fraudulent purpose, er further agrees that any use of the Mailbox applicable federal, state, and local laws. Each individual or shall be in conformity with all entity must complete a separate United States Postal '1583') to be authorized to receive mall or packages at the Service Form 1583 ('Form Mailbox. 3. This Agreement and Form 1583 shall remain confidential, except e-mail address, may be disclosed to the Center's franchis that this Agreement and Form 1583, including Custom or. The UPS Store, Inc. or its successor, solely for purpose ers name, address, and The UPS Store. Inc. and Customer related to Custom s of communication between ers use of the Mailbox, and upon written request of any law governmental agency, or when legally mandated. Upon request enforcement or other , Customer agrees to complete all necessary docume and any required acknowledgment form relating to service of process nts, including Form 1583 Form 1583 whenever any information required on this . Customer further agrees to sign a revised version Agreement or Form 1583 changes. of this Agreement and 4. Possession of the Mailbox key shall be considered valid In the event of death or incapacity of Customer, the Center evidence that the possessor is duly authorized to remove any will require the appropriate documents from the Probate contents from the Mailbox. estate, the trustee or other similar person or entity before releasin Court, the executor of the g mail or packages to a requesting party. 5. Customer agrees to pay an initial set-up fee of $30.00 (which includes a mailbox key fee and other fees associated and/or a door key fee of $0.00 (which includes an exterior door with opening a mailbox) monthly service tees and any applicable sales, use, or key fee and other fees associated with 24-hour other taxes. Mailbox service fees are all due and payable access) as well as applicable that the Center may withhold mail and packages from Custom in advance and Customer agrees er pending service. Customer agrees to pay a late fee of $30,00 If any payment payment. There will be no pro-rations or refunds for cancellation of any is not received within five (5) days of when due. In the lock is changed upon the request or fault of Customer. event the Mailbox Customer agrees to pay a fee of $10.00 . Mailbox service staled herein are subject to change. fees and other related fees In the event that Customer receives an unreasonable volume of mail or packages at the Mailbox according to the Centers the Center may require Customer to upgrade to a larger size reasonable judgment. Mailbox and pay any additional charge. The Center reserve the Mailbox service fees in the event that Customer adds addition s the right to increase al individuals or entities to the names of those individu to receive mail and packages at the Mailbox pursuant to Form 1583. als or entitles authorized Customer agrees that upon expiration, cancellation. or termination of this post office. Customer and the Center further agree that upon expiration, Agreement, Customer will not file a change of address order with the cancellation, or termination of this Agreement, Custom Center to accept and destroy any 'Unsolicited Mar (e.g., mail address er authorizes the ed to 'occupant: 'current resident: or similar designa advertising, or other promotional material) and any mall address tion; or coupons, ed to Customer that is delivered to the Center by the United Service for six months: and may refuse any package addressed States Postal Service, such ail a commercial carrier service. However, at Custom to Customer delivered by any party other than the United States Postal er's election, the Center will: a. Re-mail (i.e., forward) Customers mail (except for Unsolicited Mail) for six (I) months upon Customer's payment in advance packaging material, and forwarding fees. Customer must pay a monthly for postage. through I in advance for the time period that mall is to be re-maile forwarding fee of $5.00 for month 1, and $5.00 d. It is Customers responsibility to make arrangements with for months 2 identify Rhy mall forwarding needs prior to the expiration, cancella the Center to tion, or termination of this Agreement; or b. Store the mail or United States Postal Service package s (except for Unsolicited Mail) for up to six (I) months upon Custom advance of a storage fee of $30.0Q per month for the firne period In which er's $5.00_ for each time Customer visits the Center to pick up such the Center holds the mall or pack .gas, plus a service fee of Items. It is Customers responsibility to make arrangements to Identify any mall storage needs prior to the expiration, cancellation, or termina with the Center tion of this Agreement. 7. Six months after the expiration, cancellation, or termination of this Agreem ent, the Center may: a. Refuse any mail or package addressed to Customer and delivere d to the Center. b. Destroy any of Customers mail or packages remaining at the Center at such time. 8. Customer authorizes the Center to complete and file a Shipper's Export when necessary and to act on behalf of Customer as Customer's Declaration as 'agent' on behallof Customer as 'principal party in true and lawful agent for purposes of any and all re-mailing, including interest' e UPS Store® and Mail Boxes Etc.® Centers are independently owned and operated indirect subsidiary of United Parcel Service. Inc., a Delaware corporation. Services by licensed Franchisees of The UPS Store, Inc., Page 1 sage and may vary by location. Copyright O2012 The UPS Store, Inc. All rights , prices, and hours of operation are subject to reserved • Last updated 10/25/12 EFTA00097137  DRIVING LICENCE UK • MAXWELL • •' 2 MS GHISLAINE NOELLE M AA k Marion Ghislaine Noelle Maxwell dju in yer.di, Germany / PRESS .,.:::~::, Iv •• t -•• Ten • .. EFTA00097138  Center 5768 Electronic Journal Viewer The UPS Store Receipt View The UPS Store - #5768 III III IIIII I IIIIIII 11/20/17 10:22 AM We are the one stop for all your shipping, postal and business needs. Hours of Operation: F 9:AM - 7:PM Sat 10:AM - 5:PM Sun 12:PM - 4:PM 001 001045 (001) TO $ 10.71 Ground Residential Tracking# 1Z22E2480310982920 002 001045 (001) TO $ 10.64 Ground Residential Tracking# 1222E2480310985392 003 500248 (002) T1 $ 8.98 115 Bubble Mailer QTY 2 Reg Unit Price $ 4.49 004 063001 (004) TO $ 5.00 Key Fee NR 005 062101 (004) TO $ 198.00 FS Personal Small NR QTY Reg Unit Price $ 33.00 Start Date 11/20/17 End Date 05/20/18 006 064001 (004) TO $ 0.00 24 Hour Access NR QTY I Reg Unit Price $ 0.00 Start Date 11/20/17 End Date 05/20/18 007 064002 (004) TO $ 0.00 Call In Service NR QTY I Reg Unit Price $ 0.00 Start Date 11/20/17 End Date 05/20/18 008 064004 (004) TO $ 0.00 Pkg Notify - Emai NR QTY I Reg Unit Price $ 0.00 Start Date 11/20/17 End Date 05/20/18 009 063003 (004) TO $ 25.00 Set Up Fee NR Version 8.1.13.0 Page 1of 2 Printed 11/20/2017 10:32 EFTA00097139  Receipt View SubTotal $ 258.33 MA (T1) $ 0.57 Total $ 258.90 AMERICAN EXPRESS $ 258.90 ACCOUNT NUMBER * ************7006 Appr Code: 831971 (I) Sale ENTRY METHOD: ChipRead MODE: Issuer AID: A000000025010801 TVR: 0000008000 TSI: F800 AC: 7EAB3FA75FD8EE01 ARC: 00 Mailbox Services Transaction: Mailbox I III Customer g maxwell Thank You g maxwell Items Designated NR are NOT eligible for Returns, Refunds or Exchanges. Receipt ID 82741649203486882758 030 Items CSH: nathan Tran: 1708 Reg: 002 TRACK YOUR SHIPMENT AT: THEUPSSTORELOCAL.COM/5768 Whatever your business and personal needs, we are here to serve you. Time Sensitive Marketing Message Removed Version 8.1.13.0 Page 2 of 2 Printed 11/20/2017 10:32 EFTA00097140