EFTA00097136.pdf

in ited States Postal Service pplication for Delivery of Mall Through Agent ee Privacy Act Statement on Reverse consideration of delivery of my or our (firm) mail to the agent named below, the addressee and agent agree: (1) the addressee or the agent ust not file a change of address order with the Postal Seri/loan, upon termination of the agency relationship; (2) the transfer of mail to another idress is the responsibility of the addressee and the agent; (3) all mail delivered to the agency under this authorization must be prepaid with pm postage when redeposited in the mails; (4) upon request the agent must provide to the Postal Service all addresses to which the agency 3nsfers mail; and (5) when any information required on this form changes or becomes obsolete, the addressee(s) must file a revised ,plication with the Commercial Mall Receiving Agency (CMRA). OTE: The applicant must execute this form in duplicate in the presence of the agent, his or her authorized employee, or a notary public ie agent provides the original completed signed PS Form 1583 to the Postal Service and retains a duplicate completed signed copy at the MRA business location. The CMRA copy of PS Form PS 1583 must at all times be available for examination by the postmaster (or designee) 3cl the Postal Inspection Service. The addressee and the agent agree td comply with all applicable Postal Service rules and regulations relative delivery of mall through an agent. Failure to comply will subject the agency to withholding of mail from delivery until corrective action is taken. fis application may be subject to verification procedures by the Postal Service to confirm that the applicant resides or conducts business at the me or business address listed in boxes 7 or 10, and that the identification listed in box 8 is valid. Name in Which Applicant's Mail Will Be Received for Delivery to Agent Omplete a separate PS Form 1583 for EACH applicant. Spouses may implete and sign one PS Form 1583. Two items of valid identification ply to each spouse. Include dissimilar information for either spouse in horopriate box.) fislaine maxwell 3a.Address to be Used for Delivery (Include PMB or / sign.) 3b. City Boston 3c. State MA 3d. Zip + 4 02114 Applicant authorizes delivery to and in care of: 5. This authorization is extended to include res undersigned(s): Yes rioted defivery mail for the Name le UPS Store #5788 Address (No., street, apt./ste. no.) City iston d. State MA . Zip + 4 02114 Name of Applicant islaine maxwell L7a. Applicant Home Address (No., street, apt/ste. *wo types of identification are required. One must contain a photograph :he addressee(s). Social Security cards, credit cards, and birth 1ificates are unacceptable as identification. The agent must write in ntifying information. Subject to verification. b. City boston 7c. State MA 7d. bp +4 02114 Number (Include area code) 1IIM. .Name of Firm or Corporafion N/A Oa. Business Address (No., street, apt./ste. no.) N/A :eatable identification includes: valid drivers license or state non-driver's itification card; armed forces, government, university, or recognized ,orate identification card; passport, alien registration card or certificate aturalization; current lease, mortgage or Deed of Trust; voter or vehicle stration card; or a home or vehicle insurance policy. A photocopy of r identification may be retained by agent for verification. Ob. City N/A 10c. State N/A 10d. Zlp +4 N/A Oe. Business Telephone Number (Include area code) N/A 1. Type of Business N/A 1. Date 04/09/2018 If applicant is a firm, name each member whose mail is to be delivered. (All names listed must have verifiable identification. A guardian must list the res of minors receiving mail at their delivery address.) 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 omission of material information may result in criminal sanctions (including fines imprisonment and/or civil sanctions (including multiple damages and civil enalties) 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 Name: Center Number: 5768 Company: kddilaSS: City: boston Business Telephone: Home Telephone: Stele: ; me j ZIP: 02114 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 entered kilo by the customer Identified above ("Customer) for the use of and services related to a mailbox Mailbox" at The UPS Stara/or Mail Boxes Etc.® Center Identified above ('Center') under the terms set forth herein. 2. Customer agrees that Customer will not use the Center premises or any Center services for any unlawful. illegitimate, or fraudulent purpose, or for any purpose prohibited by U.S. postal regulations. Customer further agrees that any use of the Mailbox shall be in conformity with all applicable federal, state, and local laws. Each individual or entity must complete a separate United States Postal Service Form 1583 ('Form '1583') to be authorized to receive mall or packages at the Mailbox. 3. This Agreement and Form 1583 shall remain confidential, except that this Agreement and Form 1583, including Customers name, address, and e-mail address, may be disclosed to the Center's franchisor. The UPS Store, Inc. or its successor, solely for purposes of communication between The UPS Store. Inc. and Customer related to Customers use of the Mailbox, and upon written request of any law enforcement or other governmental agency, or when legally mandated. Upon request, Customer agrees to complete all necessary documents, including Form 1583 and any required acknowledgment form relating to service of process. Customer further agrees to sign a revised version of this Agreement and Form 1583 whenever any information required on this Agreement or Form 1583 changes. 4. Possession of the Mailbox key shall be considered valid evidence that the possessor is duly authorized to remove any contents from the Mailbox. In the event of death or incapacity of Customer, the Center will require the appropriate documents from the Probate Court, the executor of the estate, the trustee or other similar person or entity before releasing 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 with opening a mailbox) and/or a door key fee of $0.00 (which includes an exterior door key fee and other fees associated with 24-hour access) as well as applicable monthly service tees and any applicable sales, use, or other taxes. Mailbox service fees are all due and payable in advance and Customer agrees that the Center may withhold mail and packages from Customer pending payment. There will be no pro-rations or refunds for cancellation of any service. Customer agrees to pay a late fee of $30,00 If any payment is not received within five (5) days of when due. In the event the Mailbox lock is changed upon the request or fault of Customer. Customer agrees to pay a fee of $10.00 . Mailbox service fees and other related fees staled herein are subject to change. In the event that Customer receives an unreasonable volume of mail or packages at the Mailbox according to the Centers reasonable judgment. the Center may require Customer to upgrade to a larger size Mailbox and pay any additional charge. The Center reserves the right to increase the Mailbox service fees in the event that Customer adds additional individuals or entities to the names of those individuals or entitles authorized to receive mail and packages at the Mailbox pursuant to Form 1583. Customer agrees that upon expiration, cancellation. or termination of this Agreement, Customer will not file a change of address order with the post office. Customer and the Center further agree that upon expiration, cancellation, or termination of this Agreement, Customer authorizes the Center to accept and destroy any 'Unsolicited Mar (e.g., mail addressed to 'occupant: 'current resident: or similar designation; or coupons, advertising, or other promotional material) and any mall addressed to Customer that is delivered to the Center by the United States Postal Service for six months: and may refuse any package addressed to Customer delivered by any party other than the United States Postal Service, such ail a commercial carrier service. However, at Customer'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 for postage. packaging material, and forwarding fees. Customer must pay a monthly forwarding fee of $5.00 for month 1, and $5.00 for months 2 through I in advance for the time period that mall is to be re-mailed. It is Customers responsibility to make arrangements with the Center to identify Rhy mall forwarding needs prior to the expiration, cancellation, or termination of this Agreement; or b. Store the mail or United States Postal Service packages (except for Unsolicited Mail) for up to six (I) months upon Customer's advance of a storage fee of $30.0Q per month for the firne period In which the Center holds the mall or pack .gas, plus a service fee of $5.00_ for each time Customer visits the Center to pick up such Items. It is Customers responsibility to make arrangements with the Center to Identify any mall storage needs prior to the expiration, cancellation, or termination of this Agreement. 7. Six months after the expiration, cancellation, or termination of this Agreement, the Center may: a. Refuse any mail or package addressed to Customer and delivered 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 Declaration as 'agent' on behallof Customer as 'principal party in interest' when necessary and to act on behalf of Customer as Customer's true and lawful agent for purposes of any and all re-mailing, including e UPS Store® and Mail Boxes Etc.® Centers are independently owned and operated by licensed Franchisees of The UPS Store, Inc., indirect subsidiary of United Parcel Service. Inc., a Delaware corporation. Services, prices, and hours of operation are subject to sage and may vary by location. Copyright O2012 The UPS Store, Inc. All rights reserved • Last updated 10/25/12 Page 1 EFTA00097137 k • .. UK • • • ' DRIVING LICENCE MAXWELL 2 MS GHISLAINE NOELLE M AA Marion Ghislaine Noelle Maxwell dju in yer.di, Germany PRESS / Ten .,.:::~::, Iv • • t -•• EFTA00097138 Center 5768 Electronic Journal Viewer 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 The UPS Store Page 1 of 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