Part II • Blank Forms
U.S POSTAL SERVICE®
465
STAMPS BY MAIL ORDER FORM
®
Please fill out clearly and completely.
AREA CODE
DAYTIME PHONE NUMBER
First Name
Middle linitial
Last Name
Company Name (if applicable)
Apt./Suite
Mailing Address/PO Box
DETACH HERE
ITEM
ZIP+4®
State
City
DESCRIPTION
PRICE
1
41c First-ClassTM Rate Roll(s) –
100 Stamps per roll – U.S. Flag
2
41c First-Class Rate Booklet(s) –
20 Stamps per Boooklet – Forever Stamp
3
2c Stamps – 20 Stamps – Navajo Jewelry*
4
80c Stamps – 5 Stamps – Mount McKinley**
$4.00
5
17c Stamps – 10 Stamps – Big Horn Sheep***
$1.70
QTY. COST
$41.00
$8.20
TM
$.40
*May be combined for the $.41 First-Class Rate
**First ounce for Firdt-Class Rate Flat-Sized Mail
*** Additional ounce for First-Class Rate for Letter and Flat Mail.
Expected availability - June 2007
Total Cost of Order
$
PRIVACY Act Statement: Your information will be used to fulfill your request. Collection is authorized by 39 U.S.C
401, 403, & 404.
Providing the information is voluntary, but if not provided, we may not process your transaction. 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 issue; to a U.S. Postal Service auditor;
to entities, including law enforcement, as required by law or in legal proceedings; and to contractors and other
entities aiding us to fulfill the service (service providers). For more information regarding our privacy policy visit
us at usps.com.
PS Form 3227-A − April 2007
©2007 United States Postal Service
Form 38
D4477.indb 465
11/15/07 3:23:38 PM