NO CALL MISSOURI LIST REVOCATION FORM

Missouri Attorney General Jay Nixon

Call toll-free: 1-866-662-2551

I request that my name be removed from the No Call Missouri list. By removing my name from this list, telemarketers will be allowed to call me. After completing and signing this form, please return it to:

Missouri Attorney General's Office
No Call Missouri
720 Olive St., Suite 2150
St. Louis, MO 63101

CONTACT INFORMATION
Your name (first, last)
Street address
City (MO), zip
RESIDENTIAL Phone 1	(                )                         -
RESIDENTIAL Phone 2	(                )                         -
RESIDENTIAL Phone 3	(                )                         -
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Date (00-00-00)