Please remove my name and address from all list directories that you 
compile, rent, sell or trade. Below is my name and various ways my name 
may appear on mailing lists. Please register all variations of my name 
for removal from your lists:

Name ________________________________________________
Address ______________________________________________
City ___________________________ State _________________ Zip _________
Variations of my name __________________________________________________
Variations of my address ________________________________________________
Signature ________________________ Date _____________________

____________________________________________________________

(fill this out and cut on the line)..send to the following agencies:

Major marketing agencies:

ADVO, Inc.
List Services
239 West Service Road
Hartford, CT 06120

Harte-Hanks
List Removal Services
6701 Daymeadow Dr. Ste. D
Glen Burnie, MD 21060-6401

Val-Pak Coupons* 
**THIS ONE MAY REQUIRE A PERSONAL LETTER, NOT A FORM**
Direct Marketing
P. O. Box 13428
St. Petersburg, FL 33733

Direct Marketing Association** 
**THIS ONE MAY REQUIRE A SMALL FEE FOR NAME REMOVAL**
Mail Preference Service
P.O. Box 9008
Farmingdale, NY 11735

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