special.usps.com
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2600:9000:211a:8a00:13:71d4:7740:93a1
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URL:
https://special.usps.com/testkits
Submission: On August 06 via manual from US — Scanned from DE
Submission: On August 06 via manual from US — Scanned from DE
Form analysis 1 forms found in the DOM
<form novalidate="" id="otkForm" class="">
<h2 class="preorder-step-one" id="contact-information">1. Contact Information</h2>
<p>Contact information for the person placing the order.</p>
<div class="row">
<div class="col-12 col-md-6 form-group required-field"><label class="form-label" for="senderFirstName">*First Name</label><input name="firstName" required="" maxlength="40" aria-describedby="fnError" id="senderFirstName" class="form-control"
value="">
<div role="alert" id="fnError" class="invalid-feedback">Please enter first name</div>
</div>
<div class="col-12 col-md-6 form-group required-field"><label class="form-label" for="senderLastName">*Last Name</label><input name="lastName" required="" maxlength="40" aria-describedby="lnError" id="senderLastName" class="form-control"
value="">
<div role="alert" id="lnError" class="invalid-feedback">Please enter last name</div>
</div>
</div>
<div class="row">
<div class="col-12 col-md-6 form-group"><label class="form-label" for="senderEmail">Email (if you wish to receive shipping notifications)</label><input name="email"
pattern="^(?!.*(?:\.\.|\.@|^\.|@\.))($|([a-zA-Z0-9._'+-]+@[a-zA-Z0-9.-]+\.[a-zA-Z0-9]+)$)" maxlength="40" aria-describedby="emailError" id="senderEmail" class="form-control" value="">
<div role="alert" id="emailError" class="invalid-feedback">Please enter a valid email address</div>
</div>
</div>
<h2 class="preorder-step-two" id="shipping-address">2. Shipping Address</h2>
<div class="row">
<div class="col-12 col-md-12 form-group">
<div class="form-check"><input maxlength="50" type="checkbox" id="recipientSameAsSender" class="form-check-input"><label title="" for="recipientSameAsSender" class="form-check-label">First/Last Name same as above.</label></div>
</div>
</div>
<div class="row">
<div class="col-12 col-md-6 form-group required-field"><label class="form-label" for="firstName">*First Name</label><input name="firstName" required="" maxlength="50" aria-describedby="fnError" id="firstName" class="form-control" value="">
<div role="alert" id="fnError" class="invalid-feedback">Please enter first name</div>
</div>
<div class="col-12 col-md-6 form-group required-field"><label class="form-label" for="lastName">*Last Name</label><input name="lastName" required="" maxlength="50" aria-describedby="lnError" id="lastName" class="form-control" value="">
<div role="alert" id="lnError" class="invalid-feedback">Please enter last name</div>
</div>
</div>
<div class="row">
<div class="col-12 col-md-6 form-group required-field"><label class="form-label" for="address1">*Street Address / PO Box</label><input name="address1" required="" maxlength="50" aria-describedby="ad1Error"
placeholder="123 Main Street or PO Box 100" id="address1" class="form-control" value="">
<div role="alert" id="ad1Error" class="invalid-feedback">Please enter street address / PO box</div>
</div>
<div class="col-12 col-md-6 form-group"><label class="form-label" for="address2">Apt / Suite / Other</label><input name="address2" maxlength="50" placeholder="Apt A / Ste 5 / # 23" id="address2" class="form-control" value=""></div>
</div>
<div class="row">
<div class="col-12 col-md-6 form-group required-field"><label class="form-label" for="city">*City</label><input name="city" required="" maxlength="50" aria-describedby="cityError" id="city" class="form-control" value="">
<div role="alert" id="cityError" class="invalid-feedback">Please enter city</div>
</div>
<div class="col-6 col-md-3 form-group required-field"><label class="form-label" for="state">*State or Province</label><select name="state" required="" aria-describedby="stError" class="form-select" id="state">
<option value=""> Select a State</option>
<option value="AL">AL - Alabama</option>
<option value="AK">AK - Alaska</option>
<option value="AS">AS - American Samoa</option>
<option value="AZ">AZ - Arizona</option>
<option value="AR">AR - Arkansas</option>
<option value="CA">CA - California</option>
<option value="CO">CO - Colorado</option>
<option value="CT">CT - Connecticut</option>
<option value="DE">DE - Delaware</option>
<option value="DC">DC - District of Columbia</option>
<option value="FM">FM - Federated States of Micronesia</option>
<option value="FL">FL - Florida</option>
<option value="GA">GA - Georgia</option>
<option value="GU">GU - Guam</option>
<option value="HI">HI - Hawaii</option>
<option value="ID">ID - Idaho</option>
<option value="IL">IL - Illinois</option>
<option value="IN">IN - Indiana</option>
<option value="IA">IA - Iowa</option>
<option value="KS">KS - Kansas</option>
<option value="KY">KY - Kentucky</option>
<option value="LA">LA - Louisiana</option>
<option value="ME">ME - Maine</option>
<option value="MH">MH - Marshall Islands</option>
<option value="MD">MD - Maryland</option>
<option value="MA">MA - Massachusetts</option>
<option value="MI">MI - Michigan</option>
<option value="MN">MN - Minnesota</option>
<option value="MS">MS - Mississippi</option>
<option value="MO">MO - Missouri</option>
<option value="MT">MT - Montana</option>
<option value="NE">NE - Nebraska</option>
<option value="NV">NV - Nevada</option>
<option value="NH">NH - New Hampshire</option>
<option value="NJ">NJ - New Jersey</option>
<option value="NM">NM - New Mexico</option>
<option value="NY">NY - New York</option>
<option value="NC">NC - North Carolina</option>
<option value="ND">ND - North Dakota</option>
<option value="MP">MP - Northern Mariana Islands</option>
<option value="OH">OH - Ohio</option>
<option value="OK">OK - Oklahoma</option>
<option value="OR">OR - Oregon</option>
<option value="PW">PW - Palau</option>
<option value="PA">PA - Pennsylvania</option>
<option value="PR">PR - Puerto Rico</option>
<option value="RI">RI - Rhode Island</option>
<option value="SC">SC - South Carolina</option>
<option value="SD">SD - South Dakota</option>
<option value="TN">TN - Tennessee</option>
<option value="TX">TX - Texas</option>
<option value="UT">UT - Utah</option>
<option value="VT">VT - Vermont</option>
<option value="VI">VI - Virgin Islands</option>
<option value="VA">VA - Virginia</option>
<option value="WA">WA - Washington</option>
<option value="WV">WV - West Virginia</option>
<option value="WI">WI - Wisconsin</option>
<option value="WY">WY - Wyoming</option>
<option value="AE">AE - Armed Forces Europe, the Middle East, and Canada</option>
<option value="AP">AP - Armed Forces Pacific</option>
<option value="AA">AA - Armed Forces Americas (except Canada)</option>
</select>
<div role="alert" id="stError" class="invalid-feedback">Please select state or province</div>
</div>
<div class="col-6 col-md-3 form-group required-field"><label class="form-label" for="zipCode">*ZIP Code<sup>™</sup></label><input name="zipCode" pattern="^[0-9]{5}(?:-[0-9]{4})?$" maxlength="10" required="" aria-describedby="zipError"
id="zipCode" class="form-control" value="">
<div role="alert" id="zipError" class="invalid-feedback">Please enter ZIP or postal code</div>
</div>
</div>
<div class="row">
<div class="col-12 col-md-6 form-group urbanization-code-wrapper"><label class="form-label" for="uCode">Urbanization</label><input name="uCode" maxlength="28" disabled="" placeholder="Puerto Rico residents only" id="uCode" class="form-control"
value=""></div>
</div>
<div class="row">
<div class="col-12 col-md-12 expand-collapse-wrapper">
<p class="expand-collapse-header">Privacy Act Statement</p>
<div class="expandable-content">
<p>Your information will be used to provide COVID-19 Testing Kits to the address you provided, and to provide product fulfillment information about that testing kit to a federal executive agency. Collection is authorized by 39 U.S.C. 401,
403, 404, and 411. Supplying your information is voluntary, but if not provided, we may not be able to fulfill your request for a COVID-19 Testing Kit. We do not disclose your information to third parties without your consent, except to act
on your behalf or request, or as legally required. This includes the following limited circumstances: to a congressional office on your behalf; to agencies and entities to facilitate or resolve financial transactions; to a U.S. Postal
Service auditor; for law enforcement purposes involving crimes or fraud against the Postal Service; to labor organizations as required by applicable law; incident to legal proceedings involving the Postal Service; to government agencies in
connection with decisions as necessary; to agents or contractors when necessary to fulfill a business function or provide products and services to customers; for customer service purposes; and to other federal executive agencies pursuant to
39 U.S.C § 411. For more information regarding our privacy policies visit <a class="inline-link secondary" href="https://www.usps.com/privacypolicy" target="_blank" rel="noreferrer noopener">www.usps.com/privacypolicy</a>.</p>
</div>
</div>
</div>
</form>Text Content
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__PRESENT
PLACE YOUR ORDER FOR FREE AT-HOME COVID-19 TESTS
Residential households in the U.S. are now eligible for another order of free
at-home tests on USPS.com. Here's what you need to know about your order:
* Each order now includes #8 rapid antigen COVID-19 tests (FDA has more details
about at-home tests, including extended shelf life and updated expiration
dates: Authorized At-Home Over-the-Counter COVID-19 Diagnostic Tests)
* Your order of #8 tests will come in #2 separate packages (#4 tests in each
package), each with its own tracking number
* Packages will ship free
NOTE: Image of tests is only representative.
Fill in this form with your contact and shipping information to order your
tests. (If you are blind or low vision, you can get help finding more accessible
tests and using at-home tests at the Administration for Community Living's (ACL)
page, Tests for people who are blind or have low vision.)
Clear form will remove the content inside the form fields
1. CONTACT INFORMATION
Contact information for the person placing the order.
*First Name
Please enter first name
*Last Name
Please enter last name
Email (if you wish to receive shipping notifications)
Please enter a valid email address
2. SHIPPING ADDRESS
First/Last Name same as above.
*First Name
Please enter first name
*Last Name
Please enter last name
*Street Address / PO Box
Please enter street address / PO box
Apt / Suite / Other
*City
Please enter city
*State or Province Select a StateAL - AlabamaAK - AlaskaAS - American SamoaAZ -
ArizonaAR - ArkansasCA - CaliforniaCO - ColoradoCT - ConnecticutDE - DelawareDC
- District of ColumbiaFM - Federated States of MicronesiaFL - FloridaGA -
GeorgiaGU - GuamHI - HawaiiID - IdahoIL - IllinoisIN - IndianaIA - IowaKS -
KansasKY - KentuckyLA - LouisianaME - MaineMH - Marshall IslandsMD - MarylandMA
- MassachusettsMI - MichiganMN - MinnesotaMS - MississippiMO - MissouriMT -
MontanaNE - NebraskaNV - NevadaNH - New HampshireNJ - New JerseyNM - New
MexicoNY - New YorkNC - North CarolinaND - North DakotaMP - Northern Mariana
IslandsOH - OhioOK - OklahomaOR - OregonPW - PalauPA - PennsylvaniaPR - Puerto
RicoRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - TennesseeTX -
TexasUT - UtahVT - VermontVI - Virgin IslandsVA - VirginiaWA - WashingtonWV -
West VirginiaWI - WisconsinWY - WyomingAE - Armed Forces Europe, the Middle
East, and CanadaAP - Armed Forces PacificAA - Armed Forces Americas (except
Canada)
Please select state or province
*ZIP Code™
Please enter ZIP or postal code
Urbanization
Privacy Act Statement
Your information will be used to provide COVID-19 Testing Kits to the address
you provided, and to provide product fulfillment information about that testing
kit to a federal executive agency. Collection is authorized by 39 U.S.C. 401,
403, 404, and 411. Supplying your information is voluntary, but if not provided,
we may not be able to fulfill your request for a COVID-19 Testing Kit. We do not
disclose your information to third parties without your consent, except to act
on your behalf or request, or as legally required. This includes the following
limited circumstances: to a congressional office on your behalf; to agencies and
entities to facilitate or resolve financial transactions; to a U.S. Postal
Service auditor; for law enforcement purposes involving crimes or fraud against
the Postal Service; to labor organizations as required by applicable law;
incident to legal proceedings involving the Postal Service; to government
agencies in connection with decisions as necessary; to agents or contractors
when necessary to fulfill a business function or provide products and services
to customers; for customer service purposes; and to other federal executive
agencies pursuant to 39 U.S.C § 411. For more information regarding our privacy
policies visit www.usps.com/privacypolicy.
ORDER SUMMARY
FREE AT-HOME COVID-19 TESTS
Order of #8 tests
Subtotal$0.00Shipping & Handling$0.00Total$0.00
Check Out Now
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