Notice to Add or Retain Name But Not Sell or Trade It

Date: _________________
_____________________________
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[name and address of list maintainer]

To Whom It May Concern:

Please [   ] add [   ] retain my name on your mailing list. Please do not sell, trade, or share my name or address with any other company or business.
[   ] I will accept telemarketing phone calls from your company.
[   ] I do not wish to receive telemarketing phone calls from your company. Put me on your 'do not call' list.

Sincerely,

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Signature

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Print name

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Address