Pitney Bowes Account #*

Type of change (select all that apply)*

Your Pitney Bowes accounts impacted by this change (select all that apply)*

Complete the fields below for only the account information that requires a change.

Company Name

Attention

Address

City

State

Zip

Primary Phone #

Accounts Payable Contact

Accounts Payable Phone #

Equipment Operator

Equipment Operator Phone #

Additional Comments

Please provide your contact information should we have questions about this change request.

First Name*

Last Name*

Email*