Usps Postage Statement - Nonprofit Standard Mail Easy printable pdf download

United States Postal Service

Post Office: Note Mail Arrival Date & Time

Postage Statement — Nonprofit Standard Mail

Easy — Nonautomation Letters or Flats

This form may be used only for a single nonautomation price mailing of identical-weight pieces up to 3.3 ounces. Use PS Form 3602-N for all other Nonprofit Standard Mail mailings.

Checklists and other tools for mailers are available on the Postal Explorer website at: .

Telephone

Permit Holder's Name and Address, and

Post Office of Mailing

Permit No.

Weight of a Single Piece

Email Address, If Any

. ___ ___ ___ ___ ___ pound

Statement Seq. No.

If Sacked,

No. & Type

Permit Imprint

Type of

Based on

of Containers

Precanceled Stamps

Postage

Metered

125 pieces

Mailing Date

Fed Agency Code

15 pounds

USPS Nonprofit Auth. No.

Processing Category

Total Pieces

Total Weight

Letters

Flats

Customer No.

Part E

Part D

Flats — 3.3 oz. (0.2063 lb.) or Less

Letters — 3.3 oz. (0.2063 lb.) or Less

Machinable

No. of

Price

No. of

Price

Entry

Price

Total

Entry

Price

Pieces

Total

Category

Pieces

None

AADC

$0.160

None

5-Digit

$0.233

None

Mixed AADC

0.162

None

3-Digit

0.318

DBMC

AADC

0.127

None

ADC

0.350

DBMC

Mixed AADC

0.129

None

Mixed ADC

0.420

DSCF

AADC

0.118

DBMC

5-Digit

0.200

DBMC

3-Digit

0.285

Nonmachinable

None

5-Digit

0.245

DBMC

ADC

0.317

None

3-Digit

0.340

DBMC

Mixed ADC

0.387

None

ADC

0.363

DSCF

5-Digit

0.191

None

Mixed ADC

0.463

E10

DSCF

3-Digit

0.276

D10

DBMC

5-Digit

0.212

E11

DSCF

ADC

0.308

Part D subtotal

D11

DBMC

3-Digit

0.307

Part E subtotal

D12

DBMC

ADC

0.330

Total postage (add parts subtotals)

D13

DBMC

Mixed ADC

0.430

Price at Which Postage Affixed

D14

DSCF

5-Digit

0.203

Correct

Lowest

Neither

_________ pieces X $ ___ ___ . ___ ___

D15

DSCF

3-Digit

0.298

= Postage Affixed

D16

DSCF

ADC

0.321

Net Postage Due (Subtract postage affixed from total postage)

For USPS Use Only: 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.

Postmaster: Report Total Postage in

AIC 125

Total Adjusted Postage Permit Imprint

(Permit imprint only).

The mailer's signature certifies that: (1) the mailing complies with DMM 703; (2) the income derived from the sale of any products or services advertised in the mailing is not subject to the

Unrelated Business Income Tax (UBIT) and any products and services advertised are substantially related to the nonprofit organization's authorized purpose within the meaning of 39 U.S.C.

3626(j)(1)(d)(ii)(I) and 26 U.S.C. 513(A); (3) the mailing if made by a voting registration official is required or authorized under the National Voter Registration Act of 1993; and (4) it will agree to

pay, subject to appeal, any revenue deficiencies assessed on this mailing. 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 supporting documentation comply with all postal standards and

that the mailing qualifies for the rate and fees claimed; and that the mailing does not contain any matter prohibited by law or postal regulation. I understand that anyone that 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

See reverse side of form for complete USPS Use Only section.

3602-NZ,

PS Form

May 2008 PSN 7530-07-000-6219

This form and mailing standards available on Postal Explorer at .