NCOALINK PROCESSING ACKNOWLEDGMENT FORM
The collection of information on this Processing Acknowledgement Form (PAF) is required by the Privacy Act of 1974. The United States Postal Service® (USPS®) requires that each NCOALink Licensee have a completed NCOALink PAF for each of their NCOALink customers prior to providing the NCOALink service. The Licensee is also required by the USPS to retain a copy of the completed form for each of its customers and to obtain an updated PAF from each of its customers at minimum once per year. Any signature upon this PAF shall be considered valid for all purposes and have the same effect whether it is an ink-signed hardcopy document or equivalent alternative.
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Email *
Company *
Unique ID from AccuZIP6 Activation Screen
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DBA Company Name or Primary Affiliate Name (if applicable)
Mailer ID or CRID
Street (must be a street address - No PO Box) *
City *
State *
ZIP Code *
Phone *
NAICS  (NAICS Code Search) *
First and Last Name *
do hereby acknowledge that I have received and reviewed the NCOALink Information Package supplied to me by AccuZIP, Inc., an NCOALink Service Provider. I also understand that the sole purpose of the NCOALink service is to provide a mailing list correction service for lists that will be used for the preparation of mailings. Furthermore, I understand that NCOALink may not be used to create or maintain new movers’ lists.  Title
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Please read acknowledgment statement and check the box below
I do hereby acknowledge that under no circumstances shall a third party Broker, Agent, or List Administrator be considered the Mailing List owner nor have the authority to sign on behalf of the Mailing List owner.
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Licensee

Business Name:

AccuZIP, Inc.

Name:

Steve Belmonte

Telephone:

800.233.0555

Fax:

877.839.6531

NCOALink Service Provider Acknowledgment
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