Ps Form 3600-Ez - Postage Statement - First-Class Mail - Easy Nonautomation Letters, Cards, Or Flats

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United States Postal Service
Post Office: Note Mail Arrival
Date & Time (Do Not Round-Stamp)
Postage Statement—First-Class Mail—
Easy Nonautomation Letters, Cards, or Flats
Use this form for First-Class Mail.
Permit Holder
Name, Address, Email, Telephone
CRID
Federal Agency Cost Code
Statement Seq. No.
Total Pieces
Permit No.
Weight of a Single Piece
0.
pounds
Post Office of Mailing
Mailer’s Mailing Date
Total Weight
Processing Category
No. & Type
of Containers
Letters (including postcards)
Flats
Sacks
Type of Postage
Move Update Method
This is a Political Campaign Mailing
Yes
No
Alternative Method
Trays
Permit Imprint
Ancillary Service
Multiple
Pallets
Endorsement
Precanceled Stamps
OneCode ACS
Link
NCOA
This is Official Election Mail
Yes
No
Metered
n/a Alternative
ACS
Address Format
Category
Presort Level
Price
Number of Pieces
Total Postage
B1 Presorted
$0.280 x
Postcards Eligible
for Postcard Prices
B2 Single-Piece
$0.35 x
B3 Presorted
x
Letters
B5 Nonpresorted/Single-Piece
x
B12 Presorted
x
Flats
B13 Single-Piece
x
Total Postage (Add parts totals)
Price at Which Postage Affixed (Check one).
Correct
Lowest
Neither
Postage Affixed
=
.
pcs. x $
Complete if mailing includes pieces bearing metered/PC Postage or precanceled stamps.
Permit #
Net Postage Due (Subtract postage affixed from total postage)
Additional Postage Payment (State reason)
For postage affixed, add additional payment
Total Adjusted Postage Affixed
to net postage due; for permit imprint, add
additional payment to total postage.
Postmaster: Report Total Postage in AIC 121
Total Adjusted Postage Permit Imprint
(Permit Imprint Only)
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 entries?
Round Stamp (Required)
Payment Date
.
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);
By (Initials)
Time
AM
(3) proper completion of postage statement;
PM
(4) payment of annual fee; and
(5) sufficient funds on deposit (if required)
USPS Employee’s Signature
Print USPS Employee’s Name
PS Form 3600-EZ, January 2018 (Page 1 of 2) PSN 7530-07-000-6220
This form and mailing standards are available on Postal Explorer at .

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