Mailbox Service Agreement Form

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Customer Information
First Name
Last Name
Company Name (if any)
Home Address
Home Address
Home City
Home State
Home Zip Code
Home Phone
Cell Phone
Business Phone
Fax
E-Mail
Service Information

3 Months
6 Months
(+1 Free Mo.)
12 Months
(+3 Free Mo.)




Personal
(non-business use)
$105.00
$192.00
$372.00
Business
and personal
$132.00
$252.00
$468.00
Corporation
$165.00
$318.00
$588.00
Other (please
contact store)




Mailbox Type
 Personal Business/Personal Corporate
 Other (contact store)
Term of Service 3 months  6 months  12 months
Renewal Auto Renewal (Save 5%)  Will Notify Store
Number of Mailbox Keys
24 Hour Key? No  Yes
Credit Card Information
Credit Card Type
 VISA Mastercard
 Discover American Express
Name On Card
Credit Card Number
Expiration Date
CVW (from back of card)
Billing Address
Billing Address
Billing Zip Code
Two forms of identification are required, one must have a photo: driver's license or state non-driver's ID card; armed forces, government, university, or recognized corporate ID card; passport, alien registration card or certificate of naturalization; current lease, mortgage or Deed of Trust; voter or vehicle registration card; or a home or vehicle insurance policy. Please fax (202-785-3605)or email a copy (store0740@theupsstore.com)of your IDs to expedite processing.
1st ID Type
 Driver's License State Non-driver's ID Armed Forces ID
 Passport Government Photo ID
2nd ID Type
 Driver's License State Non-driver's ID Armed Forces ID
 Passport Government Photo ID University ID
 Recognized Corp ID Alien Reg Card Cert of Naturalization
 Current Lease Mortgage Voter Registration
 Vehicle Reg Home Ins Policy Vehicle Ins Policy
Terms and Conditions

1. This Mailbox Service Agreement ("Agreement") is made and entered into by the customer entered above ("Customer"), for the use of and services related to a mailbox ("Mailbox") at The UPS Store 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 US 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 mail or packages at the Mailbox.

3. This Agreement and Form 1583 shall remain confidential except that this Agreement and Form 1583, including Customer's name, address and e-mail address, may be disclosed to the Center's franchiser Mail Boxes Etc, Inc. ("MBE") or its successor, solely for purposes of communication between MBE and Customer related to Customer's 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 one-time set-up fee of $15.00 and a refundable security/key deposit of $10.00 per key as well as applicable monthly service fees. The security/key deposit is refundable upon expiration, cancellation, or termination of this Agreement, provided that Customer returns the key/keycard and/or other similar service and pays all sums owed to the Center. 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 $15.00 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 $20.00.  Mailbox service fees and other related fees stated herein are subject to change.

In the event that Customer receives an unreasonable volume of mail or packages, at the Mailbox according to the Center's 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 entities authorized to receive mail and packages at the Mailbox pursuant to Form 1583.

6. 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 Mail" {e.g. mail addressed to "occupant", "current resident", or similar designation or coupons, advertising or other promotional material and any mail addressed to Customer that is delivered to the Center by the United States Postal Service for six (6) months and may refuse any package addressed to Customer delivered by any party other than the United States Postal Service such as a commercial carrier service. However, at Customer's election, the Center will
a. Re-mail (i.e. forward) Customer's mail (except for Unsolicited Mail) for six (6) months upon Customer's payment in advance for postage packaging material and forwarding fees. Customer must pay a monthly forwarding fee of 1 month's rent plus the cost of shipping and packing for month 1, and monthly rental fee for each month plus a $10.00 surcharge and cost of shipping and packing for months 2 through 6 in advance for the time period that mail is to be re-mailed. It is customers responsibility to make arrangements with the Center to identify any mail 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 (6) months upon Customer's payment in advance of a storage fee of monthly rental fee per each month for the time period in which the Center holds the mail or packages, plus a service fee of $10.00 for each time Customer visits the Center to pick up such items. It is Customer's responsibility to make arrangements with the Center to identify any mail storage needs prior to the expiration, cancellation, or termination of this Agreement.

7. Six (6) 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 Customer's 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 behalf of Customer as "principal party in interest" when necessary and to act on behalf of Customer as Customer's true and jawful agent for purposes of any and all re-mailing, including any re-mailing that requires the filing of a Shipper's Export Declaration by the Center (i.e. any export transaction) in accordance with the laws and regulations of the United States. Customer further agrees to provide the Center with true, accurate and complete information regarding the contents of any mail or packages to be re-mailed by the Center, whether during the term of the Agreement or after termination or cancellation.

9. Renewal. The term of this Agreement shall be the initial period paid for by Customer and any renewal period paid for by Customer from time to time. Renewal of this Agreement for  additional terms shall be at the Center's sole discretion.  Without notification, the mail box renews automatically.  Customer has the option to pay by cash or credit card or give permission for center to automatically renew with credit card authorization provided.  Auto Renewal earns a 5% discount.  30 Days written notice is required to terminate mail box without automatically renewing.

10. Customer agrees that the Center may terminate or cancel this Agreement for good cause at any time by providing Customer with written notice. Good cause shall include but is not limited to 1) Customer abandons the Mailbox, 2) Customer uses the Mailbox for unlawful, illegitimate or fraudulent purposes, 3) Customer fails to pay monies owed the Center when due, 4) Customer receives an unreasonable volume of mail or packages, 5) Customer engages in offensive, abusive or disruptive behavior toward other customers of the Center or the Center's employees, and 6) Customer violates any provision of this Agreement. Customer acknowledges that for the purpose of determining good cause for termination of this Agreement as provided herein, the actions of any person authorized by Customer to use the Mailbox will be attributed to Customer.

11. Any written notice to Customer required or permitted under this Agreement shall be deemed delivered twenty-hour (24) hours after placement of such notice in Customer's Mailbox or at the time personally delivered to Customer. In the event of a termination notice based upon abandonment of the Mailbox notice shall be deemed delivered (a) on the next day after placing in the hands of a commercial carrier service or the United States Postal Service for next day delivery or (b) five (5) davs after placement in the United States Mail by Certified Mail Return Receipt Requested, postage pre-paid, and addressed to Customer at Customer's address as set forth in Form 1583, or on the date of actual receipt, whichever is earlier.

12. As Customers authorized agent for receipt of mail, the Center will accept all mail, including registered, insured, and certified items and, if authorized on Form 1583, restricted mail (i.e. mail where the sender has paid a fee to direct delivery only to an individual addressee or addressee's authorized agent.) Unless prior arrangements have been made, the Center shall only be obligated to accept mail or packages delivered by commercial carrier services which require a signature from the Center as a condition of delivery. Customer must accept and sign for an mail and packages upon the request of the Center. Packages not picked up within 3 days of receipt by center will be subject to a storage fee of $3.00 per day per for small packages, $5.00 per day for medium packages, and large package fee will be determined by center based on size and amount of extra handling requuired, which must be paid before Customer receives the package. In the event Customer refuses to accept any mail or package the Center may return the mail or package to the sender and Customer will be responsible for any postage or other fees associated with such return. C O D items will be accepted ONLY if prior arrangements have been made and payment in advance is provided to the center. In those states where the Center is required by law to act as Customer's agent for service of process, Customer hereby authorizes the Center to act as Customer's agent for service of process, and this authorization shall remain in effect for as long as this Agreement is in effect or as long as required by state law, whichever is later. The Center agrees to follow its standard procedures for the timely placement if mail received at the Center and addressed to Customer into Customer's Mailbox and Customer hereby releases and agrees to protect, indemnify, defend and hold harmless the Center from any and all liability that may arise at any time in connection with the Center's actions or status as Customer's for service of process.

1) Customer agrees to protect, indemnify, defend and hold harmless the Center, MBE, and their respective affiliates, subsidiaries, parent corporations, franchisees officers directors, agents, and employees from and against any and all losses, damages, expenses, claims, demands. liabilities, judgments, settlement amounts, costs, and causes of action of every type and character arising out of or in connection with the use or possession of the Mailbox, including without limitation, any demands, claims, and causes of action for personal injury or property damage arising from such use or possession from failure of the United States Postal Service or any commercial carrier service to deliver on time or otherwise deliver any items (mail, packages, etc) from damage to or loss of any package or mail, or to the Mailbox contents by any cause whatsoever from any penalties, fines or other liabilities that arise out of or in connection with the Center's actions or status as Customer's agent with respect to export transactions or the Center's completion and filing of any Shipper's Export Declaration on behalf of Customer, and from any violation by Customer of applicable federal, state, or local laws, or the laws of any foreign jurisdiction.

14. Customer acknowledges and agrees that the Center is an independently owned and operated franchise of MBE and that MBE is not responsible for any acts or omissions of its franchisees.

15. CUSTOMER HEREIN AGREES THAT THE TOTAL AMOUNT OF LIABILITY OF THE CENTER AND MBE IF ANY, FOR ANY AND ALL CLAIMS ARISING OUT OF OR RELATED TO THIS AGREEMENT OR PERFORMANCE HEREUNDER SHALL NOT EXCEED $100.00 REGARDLESS OF THE NATURE OF THE CLAIM (INITIAL ___).

16. Customer must use the exact mailing address for the Mailbox without modification as set forth in Section three (3) of Form 1583. The United States Postal Service will return mail without a proper address to the sender endorsed "Undeliverable as Addressed."

17. Delivery by commercial carrier services must be made to the Center street address only (and not to a PO Box) "PO Box" may be used only if it is part of Customer's "Caller Service" (arrangement for delivery of mail through Centers using a United States Postal Service address) address format.

18. Upon signing this Agreement, Customer shall provide two (2) forms of valid identification, one of which shall include a photograph. This Agreement may not be amended or modified except in a writing signed by both parties.

19.  Package receipt limits (anything which cannot normally fit in the mail box):
      a.  Personal mail box:  5 parcels per week
      b.  Business mail box:  10 parcels per week
      c.  Corporations mail box:  15 parcels per week
      d.  Other:  Unlimited - special rates apply to mail box service

20.  Customers whose mail consistently exceeds the capacity of the rented box without notification to Center to hold mail will be asked to upgrade to the appropriate sized box.  If Customer chooses not to upgrade, Customer will be charged a $5.00 handling fee to retrieve each overflow bundle of mail.
 I have read and agree to the terms and conditions.