Ps Form 3700-1 - Postage Statement - International Mail printable pdf download

United States Postal Service

Post Office: Note Mail Arrival

Date & Time (Do Not Round-Stamp)

Postage Statement—International Mail

Use this form for all International Mailings. Only one part may be completed per mailing.

Permit Holder

Mailing Agent

Mail Owner

Name, Address, Email, Telephone

(If other than permit holder)

(If other than permit

Name, Address, Telephone

holder) Name, Address

CAPS Cust. Ref. No.

CRID

Post Office of Mailing

Mailer’s Mailing Date

Permit #

Federal Agency Cost Code

Statement Seq. No.

No. & Type

of Containers

Sacks

Type of Postage

(For Part A, C, D only)

Of total pcs., # of

Total Pieces

Weight of a Single Piece

Receipt No.

USPS-Supplied

Metered

Letters

Trays

GXG Legal-Size

Permit Imprint

Flats

Envs. (Part H Only)

Total Weight

Tare Weight

Flat Trays

M-bags

Precanceled Stamps

Mixed (C & D only)

(Less tare)

Partial Permit Imprint

Packages

Pallets

Check box if mailing is under an ICM Agreement

Direct Shipment

Other

and enter ICM Agreement No. (if applicable)

(Specify Country)

Parts Completed (Select one):

Price Tier (Select one):

N / A

Com Base

Com Plus

GEPS

Select if any extra services are included:

Subtotal Postage (Add parts totals)

Price at Which Postage Affixed (Check one).

Correct

Lowest

Neither

Postage Affixed -

Complete if mailing includes pieces bearing metered/PC Postage or precanceled stamps.

pcs. x $

Incentive/Discount Flat Dollar Amount -

Fee Flat Dollar Amount +

Net Postage Due (Line 1 + / - Lines 2, 3, 4)

Permit #

Additional Postage Payment (State reason)

Total Adjusted

For postage affixed, add additional payment to net postage due;

for permit imprint, add additional payment to total postage.

Postage Affixed

Permit Imprint Only

Total Adjusted

AIC 234 (ISAL)

AIC 243 (FCMI, FCPIS)

AIC 245 (M-Bag Airmail)

Check One

Postage Permit Imprint

AIC 235 (IPA)

AIC 244 (PMI, PMEI, GXG)

AIC 246 (Global Direct, Comm ePacket)

Report Total in AIC

Incentive/Discount Claimed:

Type of Fee:

The mailer’s signature certifies acceptance by the Mailer 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 the mailing qualifies for the prices

and fees claimed; and this mailing does not contain any dangerous articles, or articles prohibited by legislation or by postal or customs regulations. The mailer hereby certifies

that this mailing is in compliance with all applicable export laws, regulations, or orders and certifies that the mailer has provided any necessary documentation required by the USPS,

the U.S. Government, or destination country foreign government, or other authority. See the International Mail Manual for additional information. The mailer agrees to indemnify the

United States Postal Service from any and all claims, losses, costs, damages or expenses incurred by USPS as a result of mailer’s failure to comply with any applica-

ble laws or regulations. The mailer understands 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. Privacy Notice: For information regarding our Privacy Policy visit

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