Attention:

I no longer want junk mail sent to my address or unauthorized telephone calls made to my home. I hereby request that the following name(s) be removed from any mailing and/or telephone lists immediately:

Name(s):________________________________________

Address:________________________________________

City: ________________________________________

State __________ Zip: ___________________

Phone Number: ( )

Do not sell, rent, lease, or otherwise share this information. Thank you for your prompt attention to this request.

Sincerely:

________________________________________________

Sent: _________________________________________