Junk Mail Remove Form

Direct Marketing Association
MAIL Preference Service
Box 282
Carmel, NY 10512
1-212-768-7277
www.dmachoice.org

Date:_____________________

RE: Stop Junk Mail

Dear DMA:

This letter is a request for you to remove my name from your members’ mailing lists. I do not wish to receive these mail solicitations at any time. I have enclosed my $1.00 processing fee.

I am:

_____________________________________________________________
Name

_____________________________________________________________
Address

_____________________________________ __________________
City                                       State                  Zip Code

(________)____________________________
Area Code            Phone Number

Thank you,

____________________________________
Signature