United States Postal Service
Post Office: Note Mail Arrival Date & Time
Postage Statement — Periodicals All Issues in a Calendar Month
Publication Title and Owner or News Agent's Name Mailing Agent's (Printer or Consolidator) Name, Address, Telephone Number, and Email Address If Any Entry Post Office Name, State, and ZIP+4
Mailer
Customer No. CAPS Customer Ref. ID Applicable Parts Completed Rate Category (select all that apply) Classroom A B-E F Publication No. Edition/Code Issue Frequency
Printer/Consolidator Permit No. Customer No. No. and Type of Containers (enter total number of containers) First Issue Date Last Issue Date Processing Category Letters Flats Parcels Weight of one Issue (Round off to 4 decimal places if necessary) ____ ____ . ____ ____ ____ ____ pounds Advertising Percentage in Total Month's Issue ____ ____ . ____ ____ % Combined Weight of One Copy from Each Issue ____ ____ . ____ ____ ____ ____ pounds For Carrier Route Rate Pieces, Enter Date of Carrier Route Sequencing ____ ____ / ____ ____ / ____ ____ ____ ____
Regular
Nonprofit
Science-of-Agriculture Month/Year Statement Sequence No.
Mailing
No. of Issues this Month
For Automation Rate Pieces, Enter Date of Address Matching and Coding ____ ____ / ____ ____ / ____ ____ ____ ____
For Carrier Route Rate Pieces, Enter Date of Address Matching and Coding ____ ____ / ____ ____ / ____ ____ ____ ____
Part A — In-County Rates Part B — Outside County Pound Rates Part C — Outside County Piece Rates Part D — Outside County Bundle Rates
Postmaster: Report total Part A postage in AIC 224
Total Part A (Page 2)
Total Part B (Page 3) Total Part C (Page 4) Total Part D (Page 5) Total Part E (Page 6 &7) Subtotal Parts B, C, D, and E —
Postage
Part E — Outside County Sack/Tray/Pallet Rates Outside County Postage
Preferred Rate Discount - Nonprofit/Classroom subscribers and nonsubscribers within 10% limit 5% discounts (Add line B16, and parts C, D, and E Totals) _____ X .05 (all others enter zero)
Subtract the Preferred Rate Discount from the Outside County Postage Total Outside County Postage (Postmaster report in AIC 135) Add Total Outside County Postage and Total Inside County Postage
= = Total Postage
Certification
The signature of the owner of the publication 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 owner of the publication and that the owner of the publication 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 owner of the publication 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 rates 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. Privacy Notice: For information regarding our Privacy Policy visit www.usps.com.
Owner or Agent's Name
USPS Use Only
Name and Telephone Number of Contact Person in Publisher's Office
Verifying Employee's Signature
(Required) Round Stamp (Required)
Owner or Agent's Signature
Print Verifying Employee's Name Time AM PM
PS Form 3541-M1 July 2007 (Page 1 of 8) PSN 7530-05-000-4278
This form and mailing standards available on Postal Explorer at pe.usps.com.
Periodicals — All Issues in a Calendar Month — In-County Part A
In-County
Check box at left if rates are populated in this section.
Commingled nonsubscriber copies over 10% limit are not eligible for in-county rates. Report these copies on a separate PS Form 3541. Pound Rate Entry A1 DDU A2 None A3 Piece Rate (Presort) Entry / Zone A4 A5 A6 A7 A8 A9 A10 A11 A12 A13 Carrier A14 Route A15 A16 5-Digit 3-Digit Basic Presort Discount Nonautomation Automation Letters Automation Flats Nonautomation Automation Letters Automation Flats Nonautomation Automation Letters Automation Flats Basic High Density Saturation Presort Subtotal (Add lines A4 through A15) Average # of Copies Addressed Pieces Rate 0.122 0.055 0.107 0.110 0.046 0.099 0.098 0.044 0.093 0.056 0.041 0.028 Postage Subscriber Copies Nonsubscriber Copies Total Copies Total Pounds Rate $0.132 0.171 Total Pound Rate Postage (Add lines A1 and A2) Postage
A17 Number of Addressed Pieces at DDU rate ______ X $0.008 A18 Total Piece Rate Discounts (Line A17)
Piece Rate Subtotal (A16 minus A18) A19 Ride-Along Rate (Must equal the number of copies in line A16, not number of addressed pieces) A20 Ride-Along Pieces Repositionable Notes (Must equal the number of copies in line A16, not number of addressed pieces) A21 Repositionable Notes Total Copies Addressed Pieces
Total Copies
Addressed Pieces
Rate 0.155
Postage
Rate 0.015
Postage
Other Subtotal(Add lines A20 and A21) A22
Part A Total (Add lines A3 and A19) A23
PS Form 3541-M, July 2007 (Page 2 of 8)
Periodicals — All Issues in a Calendar Month — Outside-County Part B
Outside-County - Pound Rates
Check box at left if rates are populated in this section.
For Nonprofit & Classroom: All commingled nonsubscriber copies over the 10% limit must pay regular rates & use a separate PS Form 3541. Advertising Pound Rates Nonsubsc./Nonreq. Copies Entry Subscriber/Req Zone Copies W/In 10% Limit Over 10% Limit B1 DDU B2 DSCF B3 DADC B4 1 & 2 B5 3 B6 4 B7 5 B8 6 B9 7 B10 8 B11 Subtotal (Add lines B1 through B10)
Total Copies
Total Pounds
Advertising Pounds
Rate Reg. Sci/Ag .160 .209 .219 .239 .120 .157 .164 .179
Postage
.257 .303 .372 .446 .534 .610
Nonadvertising Pound Rates Total Pounds B12 DDU B13 DSCF B14 DADC B15 All Others B16
minus (From B1) (From B2) (From B3)
Advertising Pounds
equals (From B1) (From B2) (From B3)
Nonadvertising X Rate Pounds Reg Sci/Ag .133 .174 .182 .199 .133 .174 .182 .199
Postage
(From B4-B10)
(From B4-B10)
Subtotal (Add lines B12 through B15)
Pound Rate Postage Total (Add lines B11 and B16) B17
PS Form 3541-M3, July 2007 (Page 3 of 8) PSN 7530-10-000-0503
Periodicals — All Issues in a Calendar Month — Outside-County Part C
Outside-County - Piece Rates Machinable Flats
Check box at left if rates are populated in this section. Average # of Copies Addressed Pieces
Level C1 C2 C3 ADC C4 C5 3-Digit C6 C7 5-Digit C8 Nonbarcoded Nonbarcoded Barcoded Nonbarcoded Barcoded Mixed ADC Barcoded Nonbarcoded Barcoded
Presort Discount
Rate 0.404 0.431 0.350 0.370 0.331 0.348 0.268 0.276
Postage
Nonmachinable Flats and Parcels
C9 C10 C11
Mixed ADC
Barcoded (flats only) Nonbarcoded Barcoded (flats only)
0.504 0.534 0.412 0.432 0.362 0.373 0.285 0.289
ADC C12 C13 3-Digit C14 C15 5-Digit C16
Letters
Nonbarcoded Barcoded (flats only) Nonbarcoded Barcoded (flats only) Nonbarcoded
C17 C18 C19
Mixed ADC
Barcoded Nonbarcoded Barcoded
0.327 0.431 0.289 0.370 0.275 0.348 0.211 0.276
ADC C20 C21 3-Digit C22 C23 5-Digit C24 Nonbarcoded
Carrier Route & Firm Bundles
Nonbarcoded Barcoded Nonbarcoded Barcoded
C25 Basic C26 High-Density C27 Saturation C28 Firm Bundle (Use "Addressed Pieces" to calculate postage) C29 Subtotal (Add lines C1 through C28)
0.169 0.149 0.131 0.169
C30 Nonadv. % (100 minus adv.%) _____ X # of Addressed Pieces (C29) X $0.00091 Total (Line C29 minus C30) C31
PS Form 3541-M, July 2007 (Page 4 of 8)
Periodicals — All Issues in a Calendar Month — Outside-County Part D
Outside-County - Bundle Rates
Check box at left if rates are populated in this section.
Container Level D1 D2 D3 D4 D5 D6 D7 D8 D9 D10 D11 D12 D13 D14 D15 D16 D17 5-Digit SCF/ 3-Digit ADC Mixed ADC Mixed ADC ADC 3-Digit/SCF 5-Digit Firm ADC 3-Digit/SCF 5-Digit Carrier Route Firm 3-Digit/SCF 5-Digit Carrier Route Firm 5-Digit Carrier Route Firm
Bundle Level
Average # of Bundles
Rate 0.100 0.129 0.134 0.161 0.079 0.038 0.063 0.095 0.104 0.048 0.039 0.084 0.095 0.045 0.008 0.039 0.027
Postage
D18
Part D Total (Add lines D1 through D17)
PS Form 3541-M5, July 2007 (Page 5 of 8) PSN 7530-10-000-0504
Periodicals — All Issues in a Calendar Month — Outside-County Part E
Outside-County - Sack, Tray, and Pallet Rates Outside-County - Sack/Tray Rates
Check box at left if rates are populated in this section.
Container Level E1 E2 E3 E4 E5 E6 ADC Sack/Tray E7 E8 E9 E10 E11 E12 E13 E14 E15 E16 E17 E18 E19 E20 E21 E22 E23 E24 5-Digit / Carrier Route Sack/Tray 3-Digit / SCF Sack/Tray Mixed ADC Sack/Tray Origin ADC Origin SCF
Entry
Average # Sacks/Trays
Rate 0.42 0.42 0.42 1.80 1.80 1.80 1.80 1.10 0.60 1.90 1.90 1.90 1.90 1.20 1.00 0.60 2.24 2.24 2.24 2.24 1.50 1.30 0.90 0.70
Postage
Origin Post Office/DMU Origin BMC Origin ADC Origin SCF Origin Post Office/DMU Destination BMC Destination ADC Origin BMC Origin ADC Origin SCF Origin Post Office/DMU Destination BMC Destination ADC Destination SCF Origin BMC Origin ADC Origin SCF Origin Post Office/DMU Destination BMC Destination ADC Destination SCF DDU
E25
Part E Sack and Tray Total (Add lines E1 through E24)
PS Form 3541-M, July 2007 (Page 6 of 8)
Periodicals — All Issues in a Calendar Month — Outside-County Part E
Outside-County - Sack, Tray, and Pallet Rates Cont. Outside-County - Pallet Rates
Check box at left if rates are populated in this section.
Container Level E26 E27 E28 E29 E30 E31 E32 E33 E34 E35 E36 E37 E38 E39 E40 E41 E42 E43 E44 E45 E46 5-Digit / Carrier Route Pallet 3-Digit / SCF Pallet ADC Pallet Origin BMC Origin ADC Origin SCF
Entry
Average # of Pallets
Rate 18.61 18.61 18.61 18.61 13.00 8.90 22.98 22.98 22.98 22.98 14.40 12.20 6.70 26.95 26.95 26.95 26.95 17.50 15.50 8.00 1.20
Postage
Origin Post Office/DMU Destination BMC Destination ADC Origin BMC Origin ADC Origin SCF Origin Post Office/DMU Destination BMC Destination ADC Destination SCF Origin BMC Origin ADC Origin SCF Origin Post Office/DMU Destination BMC Destination ADC Destination SCF DDU
E47
Part E Pallet Total (Add lines E26 hrough E46)
PS Form 3541-M7, July 2007 (Page 7 of 8) PSN: 7530-10-000-0505
Instructions
Use this form for All Issues in a Calendar Month Periodicals mailings. Step 1: Complete Mailer and Mailing sections on page 1. Step 2: Before you complete the Postage section, go to parts A through F and complete the part(s) that pertain to your mailing. The following information will help you determine which parts to complete: Parts A — In-County piece and pound rates. Parts B — Outside-County pound rates. Parts C — Outside-County piece rates. Parts D — Outside-County bundle rates. Parts E — Outside-County sack/tray/pallet rates. Step 3: Complete only applicable part(s), as follows: 1. For In-County mailings, complete only part A. 2. For Outside-County mailings, complete applicable parts B through F. Step 4: Go to the Postage Section on page 1. Add postage from Part Total box for each completed part. Bring these totals forward to front page and insert in appropriate box. Add all parts together to get Total Postage. Step 5: Read and sign the Certification section, including your telephone number. Attach all completed pages together to submit with the mailing. (Do not include blank pages.) Information: For more information on mailing standards, rates, and fees please go to Postal Explorer at pe.usps.com.
PS Form 3541-M, July 2007 (Page 8 of 8)