Ps Form 6805 Qualified Business Mail Reply Mail Application printable pdf download

Qualified Business Reply Mail (QBRM) Application

This application is made to distribute Qualified Business Reply Mail (QBRM) cards, or other letter-sized pieces prepared

and distributed for return without prepayment of postage under Mailing Standards of the United States Postal Service,

® )

Domestic Mail Manual (DMM

507. QBRM rates and the additional per piece fee will be paid on all pieces returned under

this privilege.

Applicant agrees to prepare pieces in accordance with DMM 201, 507, and 708, and understands that failure to comply with

these requirements may result in an inability to receive QBRM rates. Applicant must submit this completed form and either:

1. 10 actual Business Reply Mail™ (BRM) samples.

2. 10 paper mockups cut to the dimension of the BRM piece, PMS ink color, and a pre-production sample or artwork.

QBRM service reduced First-Class Mail

service postage rates and applicable per piece fees apply on cards and letter-sized

pieces.

NOTE: The addresses of mailpieces distributed under the QBRM program must include the unique ZIP + 4

that is pre-

assigned for the BRM piece and that identifies the type of BRM piece, the applicable rate, and the individual permit holder.

A. Enter each BRM ZIP + 4 and a indicate with a checkmark the rate(s) at which your QBRM service will be returned.

1. Basic QBRM Service

2. High Volume QBRM Service

Postcard Rate

1 Oz. Letter Rate

2 Oz. Letter Rate

Postcard Rate

1 Oz. Letter Rate

2 Oz. Letter Rate

ZIP + 4

(

($.358 + .24 + .06 = .658)

(

$.211 + .06 = .271)

$.358 + .06 = .418)

$.211 + .008 = .219)

$.358 + .008 = .366)

($.358 + .24 = .606)

ii.

iii.

iv.

B. Permit Information

1. Permit No.

2. City and State of Issue

3. Holder's Name

C. Mailpiece Information

1. Attention Line

2. Company/Organization Name

3. Street/PO Box

4. City, State, ZIP + 4

D. Contact Person

1. Printed Name

By signing this application, I certify that all future QBRM

envelopes/cards will be produced with equivalent paper stock,

and will meet the paper thickness requirements of 0.007 inch for

2. Title

postcard dimension and 0.009 inch for other letter-size dimensions.

NOTE: Failure to meet other requirements may result in an

inability to receive QBRM rates.

3. Telephone Number (Including area

4. Fax Number (Include area code)

6. Date

5. Signature

code and extension if appropriate)

Send this completed form and attachments to the postmaster or business mail entry manager at the Post Office™

to which the QBRM pieces are to be returned. Include the complete street address, city, state, and ZIP + 4.

6805,

This form is on the Internet at

PS Form

December 2005 (Page 1 of 2)

Ps Form 6805 Qualified Business Mail Reply Mail Application

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