Ps Form 3621-A - Renewal Notice For Annual Fee(S)
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1Renewal Notice for
Annual Fee(s)
Permit
Period Covered
Type of Fee
Number
Fee
Amount Paid
(Month/Year
–
Month/Year)
Business Reply Mail
®
$225.00
$
Annual Permit Fee
Business Reply Mail
$685.00
$
Annual Account Maintenance Fee
First-Class Mail
®
$225.00
$
Presort Annual Mailing Fee
USPS Marketing Mail
™
$225.00
$
Annual Mailing Fee
Bound Printed Matter
$225.00
$
Destination Entry Annual Mailing Fee
Customer Registration ID Number (CRID)
$
Total Amount Enclosed
Company Name
Customer Name
Address (Number, street, suite, apt., etc.)
City
Telephone Number (Include area code)
State
®
ZIP+4
£
Verify that the Permit Number column shows the correct number or numbers that apply to your account(s).
£
In the Period Covered column, enter the full 12-month period during which you will use the service.
£
In the Amount Paid column, enter the fee amount(s) you are paying.
£
Enter the total amount paid.
£
Make your check payable to Postmaster and mail it to the following address:
POSTMASTER
We appreciate your business. If you have any questions, please call
.
3621-A
PS Form
, September 2017
PSN 7530-02-000-8210
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Parent category: Life