Need an address list? Please complete the form below. We will contact you to discuss your request in greater detail.
Thank you for the opportunity to provide a list quotation.

Name (required):
Address:
City:
State:
Zip Code:
Phone Number (required):
E-Mail (required):
Type of List: (Please Select One):
Consumer List (e.g. Households, Homeowners, Individuals)   Business List (e.g. Companies, Industry Types)
Geography Selection (Please enter your selection criteria below that best describes your list requirements):
State (Enter the abbreviation of the state(s) you would like included in the list.):
City (Enter the city(ies) and state(s) you would like included in the list.):
County (Enter the county(ies) and state(s) you would like included in the list.):
ZIP Code (Enter either the 3-digit ZIP Code(s) or 5-Digit ZIP Codes you would like included in the list.):
Radius (Enter the radius, in miles you would like included in the list.):
(Enter the street address that will serve as the center of the radius):
Optional Criteria In addition to the geographic criteria detailed above, feel free to add any of the following to your list requirements. Please note that all not all criteria will work with every list.
Age (Enter the desired age or age range.):
Gender (Consumer List Only):	Both   Male   Female
Annual Household Income (Consumer List Only) (Enter the desired annual income or annual income range.):
Home Ownership (Consumer List Only):
Both   Home Owner   Renter
Home Market Value (Consumer List Only): (Enter the desired market value or market value range.):
Length of Residency (Consumer List Only): (Enter the desired Length of Residency or Length of Residency range.):
Children In The Home (Consumer List Only):
Yes   No
SIC Code (Business List Only) (Enter the SIC Code(s)):
Employee Head Count (Business List Only) Age (Enter the desired employee head count.)
Annual Sales Volume (Business List Only) Age (Enter the desired annual sales volume.):
Years in Business (Business List Only) Age (Enter the desired number of years in business.):
Additional Items To Include In List:
In the space below, please briefly provide any other desired demographics, (e.g. lifestyles, buying patterns) or criteria that will help you target your specific market.

Notice: All service quotations are based on information provided on this form and in verbal communications with the customer and are subject to a physical review of the mailpiece to assure compliance with USPS requirements.

If you have problems with this form, or if you require immediate assistance, please call us at
1-800-653-3121.

All service quotations are subject to the terms and conditions specified in our Service Customs.