Usps - Application For Refund Of Fees, Products And Withdrawal Of Customer Accounts Page 2
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2Part 3 - Postage or Meter Stamps (excluding PC Postage®)
(For Official Use Only)
The customer's meter must be licensed at the refunding office, and complete, legible, and valid unused meter stamps must be submitted by the licensee
within 60 days from the dates shown on the indicia. Those produced by PC Postage systems are not refundable at the window. Charges are assessed at
10% off the face value of the indicia, if the total is $350 or less. If the total face value is more than $350, a charge of $35 per hour is assessed for the actual
hours to process the refund; the minimum charge is $35.
Meter Manufacturer
Meter Serial No.
Meter License
(Group and list by postage units or value)
(Group and list by postage units or value)
Number of Pieces
Amount Each
Postage Value
Number of Pieces
Amount Each
Postage Value
Total Postage Value
Total Postage Value
$
Grand Total of Postage Value
_
Less Charges
(10% of face value or $35 per hour if over $350. Minimum charge is $35.)
Post Offices must destroy customer meter stamps to prevent reuse. The manager and
$
Total To Be Refunded
a witness must sign to certify that the meter impressions listed above were destroyed.
Supervisor/Manager Signature
Date
Witness Signature
Date
Part 4 - Special Services and Other Refunds
(Note: Fees for registered, insured, and COD services are not ordinarily refundable.)
Explain the reason for the requested refund:
Amount of Refund to Which Claimant is Entitled
$
(In accordance with USPS policy)
Part 5 - Disbursements for Refunds
(Issued Locally)
1) Postal Service official and witness must verify this claim and enter the approved amount in the “Approved Amount of Disbursement”.
2) Certifying Postal Service official and witness are required to print and sign as authorization for payment or withdrawal of trust account.
3) Ensure the proper accounting entries are performed on PS Form 1412.
4) For cash refund issued, obtain payee’s signature below. For money order refund issued enter the money order serial number below.
5) DO NOT SUBMIT PS Form 3533 to Scanning and Imaging Center if a refund is issued locally.
Payee Signature or Money Order Serial Number:
Date
Part 6 - Disbursements Processed by the Accounting Service Center (ASC)
1) Postal Service official and witness must verify this claim and enter the approved amount in the “Approved Amount of Disbursement”.
2) Certifying Postal Service official and witness are required to print and sign as authorization for payment or withdrawal of trust account.
3) Ensure the proper accounting entries are performed:
a) If this is a refund, use the appropriate AIC for the refund. (See “Request Disbursement For” section.)
b) If this is a withdrawal from an advance deposit account, use the appropriate AIC 453 for BRM/Postage Due or AIC 470 for permit.
c) Ensure the offset to AIC 280, Disbursement Sent to ASC, is performed either in Form 1412 or Postal One!® system.
d) Attach the supporting AIC 280 documentation (PS Form 3544 or 3533-X) to the PS Form 3533.
4) SUBMIT PS Form 3533 with attached AIC 280 supporting documentation to the USPS Scanning and Imaging Center.
5) Customer will receive the payment from USPS. NOTE: Maintain a copy of the PS Form 3533 locally for 90 days.
3533,
PS Form
November 2006 (Page 2 of 2)
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