Ps Form 3600-Fcm - Postage Statement - First-Class Mail And First-Class Package Service

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United States Postal Service
Post Office: Note Mail Arrival
Date & Time (Do Not Round-Stamp)
Postage Statement—First-Class Mail
and First-Class Package Service
Use this form for First-Class Mail and First-Class Package Service.
Permit Holder
Mailing Agent
Mail Owner
Name, Address, Email, Telephone
(If other than permit holder)
(If other than permit holder)
Name, Address, Telephone
Name, Address
CAPS Cust. Ref. No.
CRID
CRID
CRID
Post Office of Mailing
Mailer’s Mailing Date
Federal Agency Cost Code
Statement Seq. No.
Permit #
No. and type
of Containers
Sacks
Type of Postage
Processing
For Mail Enclosed
Weight of a Single Piece
SSF Transaction ID#
Parcels Only Hold
Category
within Another Class
.
For Pickup (HFPU)
1 ft. Letter
Permit Imprint
pounds
Trays
Letters
Marketing Mail
Precanceled
No. of pieces
Stamps
2 ft. Letter
Total Pieces
Total Weight
Flats
Bound Printed Matter
Customer Generated
Trays
Metered
Parcels
Library Mail
Electronic Labels
EMM Letter
Periodicals
SigCon
Move Update Method
Letter or flat-size mailpieces contain:
Trays
Media Mail
Round Trip ONLY: One DVD/CD or other disk.
Ancillary Service
Alternative Method
For Automation Price Pieces,
Flat Trays
Endorsement
Enter Date of Address
Multiple
Combined Mailing
Pallets
This is a Political Campaign Mailing
Yes
No
Matching and Coding
NCOA
Link
OneCode ACS
Single Class
ACS
Other
n/a Alternative
This is Official Election Mail
Yes
No
/
/
Address Format
Parts Completed (Select all that apply):
A
B
C
D
S
NSA
1
Subtotal Postage (Add parts totals)
Price at Which Postage Affixed (Check one).
Correct
Lowest
Neither
2
Postage Affixed -
=
Complete if mailing includes pieces bearing metered/PC Postage.
pcs. x $
.
3
Incentive/Discount Flat Dollar Amount -
4
Fee Flat Dollar Amount +
Net Postage Due (Line 1 + / - Lines 2, 3, 4)
Permit #
5
Additional Postage Payment (State reason)
For postage affixed, add additional payment to net postage due;
Total Adjusted Postage Affixed
for permit imprint, add additional payment to total postage.
Total Adjusted Postage Permit Imprint
Postmaster: Report Total Postage in AIC 121
Incentive/Discount Claimed:
Type of Fee:
The mailer’s signature certifies acceptance of liability for and agreement to pay any revenue deficiencies assessed on this mailing, subject to appeal. If an agent signs this form,
the agent certifies that he or she is authorized to sign on behalf of the mailer and that the mailer is bound by the certification and agrees to pay any deficiencies. In addition,
agents may be liable for any deficiencies resulting from matters within their responsibility, knowledge, or control. The mailer hereby certifies that all information furnished on this
form is accurate, truthful, and complete; that the mail and the supporting documentation comply with all postal standards and that the mailing qualifies for the prices and fees
claimed; and that the mailing does not contain any matter prohibited by law or postal regulation. I understand that anyone who furnishes false or misleading information on this
form or who omits information requested on this form may be subject to criminal and/or civil penalties, including fines and imprisonment.
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Signature of Mailer or Agent
Printed Name of Mailer or Agent Signing Form
Telephone
Weight of a Single Piece
Total Weight
Are postage figures at left adjusted from mailer’s
Round Stamp (Required)
Payment Date
.
entries?
Yes
No If yes, reason:
pounds
Total Pieces
Total Postage
Presort Verification Performed? (If required)
Yes
No
I CERTIFY that this mailing has been inspected for
Date Mailer Notified
Contact
each item below if required:
(1) eligibility for postage prices claimed;
(2) proper preparation (and presort where required);
(3) proper completion of postage statement;
By (Initials)
Time
AM
(4) payment of annual fee; and
PM
(5) sufficient funds on deposit (if required)
USPS Employee’s Signature
Print USPS Employee’s Name
PS Form 3600-FCM1, January 2018 (Page 1 of 6) PSN 7530-13-000-5569
This form and mailing standards are available on Postal Explorer at .

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