Business Mail Acceptance Worksheet
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1BUSINESS MAIL ACCEPTANCE WORKSHEET
11. Is the USPS piece count (Line 7) within the range on Line 10?
Date: ____________________________ Permit : ________________
Yes
No
a. If yes, accept mailer’s piece count.
Mailing Agent: _____________________________________________
b. If no, proceed to Line 12.
12. Tare Weight from Column 2: _________________________________ lbs.
Permit Holder: _____________________________________________
13. Tare Correction Factor:
Type and Amount of Tare Weight
Line 12 x .1 = ________________________________________________ lbs.
2.
1.
3.
14. Tare Correction Piece Count:
÷
Sacks / Trays / Pallets only
Total USPS
Line 6 = __________________________________________ pcs.
Rolling Stock
Line 13
Weight
(Gross)
Qty. X
lbs. =
Weight
and all others
15. Range of Difference:
Line 14 = ________________________________________ pcs.
+
Line 10a
Line 14 = _________________________________________ pcs.
-
Line 10b
16. Is the USPS piece count (Line 7) within the range on Line 15?
Yes
No
a. If yes, accept mailer’s piece count.
b. If no, proceed to C.
B. Piece/Pound Price
1. USPS Net Weight (Line 5) ______________________________ lbs.
2. Pounds declared by Mailer ____________________________ lbs.
3. Difference (B1 – B2) _________________________________ lbs.
÷
B1) x 100 ________________ lbs.
4. Percentage of Difference (B3
5. Is the Percentage of Difference less than or equal to 1%?
Yes
No
a. If yes, accept mailer’s declared pounds.
b. If no, proceed to C.
C. Percentage of Difference exceeds 1%
Give Mailer options:
1. Correct or withdraw the mailing. Complete lines below.
2. Adjust mailing statement to USPS Piece Count/USPS Net
Weight. Complete lines below. (If mailer chooses this option, but
4. Totals
under protest, remind the mailer that a written appeal must be
filed within 15 days according to DMM, 607.2.)
A. Piece Count
Adjustments:
5. Net Weight:
Customer Contact: ___________________________________________
Column 3) = ____________________ lbs.
+
Column 1 – (Column 2
Date and Time Contacted: _____________________________________
6. USPS Piece Weight: _____________________________________ lbs.
Action Taken: _______________________________________________
7. USPS Piece Count:
÷
Line 6 = ________________________________________ pcs.
Line 5
__________________________________________________________
8. Pieces claimed by the Mailer: ___________________________ pcs.
__________________________________________________________
9. Line 8 x .01 = _______________________________________ ____ pcs.
Employee Completing Form:
+
Line 9 = _____________ pcs.
10a. Pieces claimed by the Mailer
__________________________________________________________
-
Line 9 = _____________ pcs.
b. Pieces claimed by the Mailer
PS Form 8040, August 2010
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