CHANGE or VERIFY ADDRESS FORM

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Name__________________________________ID#(required) ____________

NEW ADDRESS:

Business Name optional)_________________________________________

Address_________________________________________________________

City:___________________________________________________________

State/Prov:________________________ Zip/Postal Code_____________

Country:________________________________________________________

Telephone_______________________________________________________

Fax:____________________________________________________________

email:__________________________________________________________

PREVIOUS ADDRESS:

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Mail to:

IFPO-ADDRESS CHANGE/VERIFY
P.O. Box 777, LEWISVILLE NC 27023-0777

FAX to:

336-945-3711


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P.O. Box 42, Hamptonville, NC 27020-0042
phone: 336-945-9867, fax: 336-945-3711
ORDERS ONLY:
1-800-654-9557 or fax 1-800-283-5989

Current GMT Date/Time: Sunday, March 14, 2010 / 10:28:49