(date)

Mail Preference Service
c/o Direct Marketing Association
P.O. Box 9008
Farmingdale, NY 11735-9008

To whom it may concern:

I am writing to register with your Mail Preference Service. Please inform your members that I do not want my name sold to any company for the purpose of placing me on the mailing list and sending me advertising mail.

In addition, I would like my name removed from all existing lists.

Thank you very much for your help.

Sincerely,

(your name)
(your address)