you must complete the opt-out notice form by providing the information called for in the form , including your name , address -lrb- including street address , city , state and zip code -rrb- , and the user id -lrb- s -rrb- and email address -lrb- es -rrb- associated with the ebay account -lrb- s -rrb- to which the opt-out applies .