PS 604

Credit Card Non-Receipt Report (10/2006)

Download and Print the PS 604

To: Postal Inspector in Charge
The below named addressee has advised us that he or she did not receive the credit card we mailed.

Instructions
Keep Part 2. Send Part 1 to the Postal Inspector in Charge of the division in which your place of business is located. Find the location at http://www.usps.com/ncsc/locators/find-is.html. Additional copies of this
form will be given to the Postal Inspector in Charge on request.

1a. Name of Addressee 1
1b. Street Address (No., street, apt./ste./PO box no.)
2b. Street Address (No., street, apt./ste./PO box no.)
1c. City 1d. State 1e. ZIP + 4® 2c. City 2d. State
f. Telephone Number (Include area code)

2a. Name of Mailer 2f. Telephone Number (Include area code)

3. Date Mailed

4. Mailed at (Location, city, state, ZIP + 4)

5a. Type of Card (American Express, Discover, MasterCard, Visa, etc.) 5b. Card Number 5c. Expiration Date

6. Where were purchases made? 7. Date Purchases Began (MM/DD/YYYY) 8. Total Amount of Purchase(s) $

9. Postal Inspector Use
PS Form 604, October 2006 PSN 7530-02-000-9430 1-Postal Inspector in Charge 2- Keep for Your Records

And much more...