PRESTWICK MAILBOX ORDER FORM



As owner of the below stated property, I hereby authorize you to construct and erect
the Architectural Review Board’s approved mailbox system. This will be located per
instructions of the U.S. Postal Service.

PLEASE PRINT

Date of Request: __________________________

Phase: _____ Lot # : _____


Name: ______________________________________________


Street Address: _______________________________________


Last Name to appear on Mail Receptacle: *____________________

PLEASE RETURN THIS FORM TO THE FOLLOWING ADDRESS
WITH A CHECK FOR $175.00 (New Mailbox Installation and maintenance)
Or $ 55.00 (Name Change on existing mailbox)

MADE PAYABLE TO: PRESTWICK POA
605 Briarwood Drive, Suite C
Myrtle Beach, SC 29572

Your mailbox will be installed within 2-3 weeks from the date that this form is received.


*THE LAST NAME OF THE PROPERTY OWNER WILL BE PLACED ON THE FRONT OF THE
MAILBOX UNLESS INSTRUCTED OTHERWISE. PLEASE SIGN BELOW IF YOU DO NOT
WANT THE NAME TO APPEAR ON THE MAILBOX.

Signature: _________________________________________________

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