PS 1093-A PDF Details

For those looking to streamline the management of their Post Office Box™ services, the PS Form 1093-A offers a convenient solution. This form, designated for current Post Office Box customers, introduces simplicity and efficiency into the renewal process through automatic recurring payments. Applicants are required to provide comprehensive information, including personal or business name, email address for payment notifications, and the relevant PO Box details. A significant feature of this form is the optional automatic renewal payment agreement, which allows users to authorize the United States Postal Service® (USPS®) to charge their credit card for the PO Box service according to the selected schedule—be it every 3, 6, or 12 months. To ensure timely notifications and prevent service interruptions, the form encompasses provisions for email alerts regarding upcoming charges, as well as changes in credit card information. Also included are the implications of failed payments, which could lead to the closure of the PO Box and potential reactivation fees. It's crucial to acknowledge the commitment to accuracy and truthfulness required when completing this form, as any discrepancies could result in criminal or civil penalties. Through the PS Form 1093-A, the USPS® underlines its dedication to providing secure and efficient service while emphasizing the importance of customer responsibility in maintaining their payment and personal information up-to-date. Furthermore, the form reinforces privacy commitments, specifying the conditions under which personal information may be disclosed, thereby ensuring users of the USPS's adherence to privacy policies.

QuestionAnswer
Form Name PS Form 1093-A
Form Length 1 pages
Fillable? Yes
Fillable fields 13
Avg. time to fill out 2 min 51 sec
Other names usps 1093a form, 1093a form usps, form 1093a ps

Form Preview Example

Application for Post Office Box™ Service

Automatic Recurring Renewal Payment

(Current Post Office Box Customers Only)

Fill out all non-shaded fields and take this application to the Post Office.

 

 

 

 

 

 

 

1.

Name

of

Applicant (Last, First, MI) (include title if representing a business/organization)

2.

Email Address (required for automatic payment notifications)

 

 

 

 

 

 

 

3.

Name

of

Business/Organization (if applicable)

4.

PO Box Number(s)

 

 

 

 

 

 

 

5.PO Box ZIP Code(s) (if more than one ZIP Code, specify which box numbers in item 4 are associated with each ZIP Code)

Optional Automatic Renewal Payment — Terms and Agreement (Required for 3-month payment option)

 

 

 

 

 

By

initialing below

and

establishing

automatic renewal payments at

a

Post Office, I hereby authorize the U.S. Pos

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

®

 

(USPS®) to charge

my credit

card for the amount

of

my

designated

box

size

per USPS pricing on the scheduled

I have selected

(i.e.,

3,

6, or

12 months). This

charge

could

appear

on

my

credit

card statement

as

early as th

the

month prior to

the

due

date.

If

I provided

my

e-mail

 

address,

I understand that

I will receive

e-mail

notificatio

10 days prior to the actual credit

card charge.

I will

also

receive a

payment

due notice in my PO Box before

date. I understand

that I may

cancel

the automatic payment

option

any

time

after the initial application/payment p

complete during the business hours

at the Post Office where my box

is located. If I do not cancel

by

the 14t

prior to the next payment due date, I understand that

the

 

payment

will

be

charged to my credit card.

I underst

payment cannot be transacted due

to

incorrect

or obsolete

payment

information or

the

transaction wouldcreit exceed

limit of the account, or

the

bank

or

credit

card company

rejects/returns

the

payment request, my PO Box may

and any mail received after closure

would

be returned

to

 

the

sender. If my

PO Box is closed for nonpayment,

that

I could be

charged

a late payment fee to

reactivate

my

PO

Box

service. If there

are

any

changes

to my

number, billing address, or expiration date, I agree to notify

the Post

Office

where my box is located of these

understand that this agreement will

remain in effect until I or USPS terminates the

PO

Box service.

The USPS

updated

credit

card account information

from

the

institution

 

that issued the card identified

for

payment.

If

I decide

my

PO

Box,

I must

visit the Post

Office where my box is located during business hours.

(See

the

PO

Box re

information on refunds.) The USPS may terminate my participation under this

automatic payment agreement in th

provide incorrect, false, or fraudulent account information or

if

I have

any returned payment

items.

 

 

 

Customer Initials __________ Billing Address (associated with editcr card):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Number, Street, Suite______________________________________________________________________________________________________________________

City ______________________________________________________________________________ State

AL

 

®

 

 

 

 

 

 

 

 

ZIP+4 ____________________________

Application

Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of Applicant (Same as item 1)

I certify that all information furnished on this form is accurate, truthful, and complete. I understand that anyone who furnishes false or misleading information on this form or omits information requested on this form may be subject to criminal and/or civil penalties, including fines and imprisonment.

________________________________________________________________________________

Post Office Date Stamp

Privacy Act Statement: Your information will be used to provide Post Office Boxservice and to ensure delivery to the box. Collection is authorized by 39 U.S.C. 401, 403, and 404. Providing the information is voluntary; but, if not provided, we will be unable to provide this service to you. We do not disclose your information to third parties without your consent, except to facilitate the transaction, to act on your behalf or request, or as legally required. This includes the following limited circumstances: to a congressional office on your behalf; to financial entities regarding financial transaction issues; to a U.S. Postal Service®

auditor; to entities, including law enforcement, as required by law or in legal proceedings; to contractors and other entities aiding us to fulfill the service (service providers); to process servers; to domestic government agencies if needed as part of their duties; and to a foreign government agency for violations and alleged violations of law. Information concerning an individual box holder who has filed a protective court order with the postmaster will not

be disclosed except pursuant to court order. For more information regarding our privacy policies, visit usps.com/privacypolicy.

©2011 United States Postal Service®. All Rights Reserved. The Eagle Logo, PO Box and Your Other Address are some of the many trademarks of the U.S. Postal Service®.

PS Form1093-A, January 2012 PSN 7530-13-000-7160

How to Edit PS Form 1093-A Online for Free

Handful of things are quicker than filling in documentation with the help of the PDF editor. There isn't much for you to do to update the 1093 form usps file - merely abide by these steps in the following order:

Step 1: Choose the "Get Form Here" button.

Step 2: Now you are on the form editing page. You may edit, add text, highlight particular words or phrases, place crosses or checks, and put images.

To get the template, type in the details the system will require you to for each of the appropriate segments:

portion of empty spaces in how to 1093 a

Enter the required details in the segment Customer, Initials Number, Street, Suite City, State, ZIP, Application, Date PostOffice, Date, Stamp and PS, Form, A, January, PSN

how to 1093 a CustomerInitials, NumberStreetSuite, City, State, ZIP, ApplicationDate, PostOfficeDateStamp, and PSFormAJanuaryPSN fields to fill

Step 3: Hit the button "Done". The PDF form can be transferred. You will be able download it to your device or email it.

Step 4: You may create copies of your form toremain away from all of the possible future troubles. You need not worry, we don't disclose or record your data.

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