ps3602n

United States Postal Service Post Office: Note Mail Arrival Date & Time Postage Statement — Nonprofit Standard Mail Permit Holder's Name and Address and Email Address, If Any Telephone Name and Address of Mailing Agent (If other than permit holder) Telephone Name and Address of Individual or Organization for Which Mailing Is Prepared (If other than permit holder) Mailer USPS Nonprofit Auth. No. CAPS Cust. Ref. No. Customer No. Post Office of Mailing Type of Postage Permit Imprint Precanceled Stamps Metered Customer No. Processing Category Letters Flats Parcels - Machinable Parcels - Irregular Letters - Paid as NFMs ECR Letters - Paid as ECR Flats CMM NFM Customer No. Federal Agency Cost Code Statement Seq. No. No. and type of Containers Total Pieces pounds Total Weight both Mailing Date Weight of a Single Piece ____ Sacks ____ 1 ft. Letter Trays ____ 2 ft. LetterTrays ____ EMM Letter Trays ____ Flat Trays ____ Pallets ____ Other Mailing 0 ____ . ____ ____ ____ ____ Periodicals Media Mail Parcel Post Permit # For Mail Enclosed within Another Class Bound Printed Matter Library Mail If Sacked, Based on 125 pcs 15 lbs. For Automation Rate Pieces, Enter Date of Address Matching and Coding ____ ____ / ____ ____ / ____ ____ ____ ____ Parts Completed (Select all that apply) For Enhanced Carrier Route Rate Pieces, Enter Date of Address Matching and Coding ____ ____ / ____ ____ / ____ ____ ____ ____ For Enhanced Carrier Route Rate Pieces, Enter Date of Carrier Route Sequencing ____ ____ / ____ ____ / ____ ____ ____ ____ A B C D E F G H I J K L S Total Postage Postage Rate at Which Postage Affixed (Check one) Neither Correct Lowest (Add parts totals) _________ pcs. x $ _____ . ______ = Postage Affixed Net Postage Due For USPS Use Only: Additional Postage Payment (State reason) (Subtract postage affixed from total postage) For postage affixed add additional payments to net postage due; for permit imprint add additional payment to total postage. Postmaster: Report Total Postage in (Permit Imprint Only) Total Adjusted Postage Affixed Total Adjusted Postage Permit Imprint AIC 125 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 the supporting documentation comply with all postal standards and that 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. Signature of Mailer or Agent Weight of a Single Piece Printed Name of Mailer or Agent Signing Form Are postage figures at left adjusted from mailer's entries? If "Yes" state reason. Telephone Certification Yes No 0 ____ . ____ ____ ____ ____ pounds Total Pieces Total Weight Total Postage Round Stamp (Required) USPS Use Only Presort Verification Performed? (Check one) Yes No I CERTIFY that this mailing has been inspected concerning: (1) eligibility for postage rates claimed; (2) proper preparation (and presort where required); (3) proper completion of postage statement; and (4) payment of annual fee (if required). Verifying Employee's Signature Date Mailer Notified Contact By (Initials) Print Verifying Employee's Name Time AM PM PS Form 3602-N1, June 2007 (Page 1 of 11) PSN 7530-07-000-6213 This form and mailing standards available on Postal Explorer at pe.usps.com. Nonprofit Standard Mail Part A Automation Letters Check box at left if rates are populated in this section. Letters 3.3 oz. (0.2063 lbs.) or less Rate Entry Category A1 A2 A3 A4 A5 A6 A7 A8 A9 A10 A11 None None None None DBMC DBMC DBMC DBMC DSCF DSCF DSCF 5-Digit 3-Digit AADC Mixed AADC 5-Digit 3-Digit AADC Mixed AADC 5-Digit 3-Digit AADC Rate $0.127 0.142 0.147 0.161 0.094 0.109 0.114 0.128 0.085 0.100 0.105 No. of Pieces Total Letters Over 3.3 oz. up to 3.5 oz.- Rate includes a discount that equals the flats piece rate minus the letter piece rate. Entry A12 A13 A14 A15 A16 A17 A18 A19 A20 A21 A22 None None None None DBMC DBMC DBMC DBMC DSCF DSCF DSCF Rate Category 5-Digit 3-Digit AADC Mixed AADC 5-Digit 3-Digit AADC Mixed AADC 5-Digit 3-Digit AADC Piece Rate 0.001 0.016 0.021 0.035 0.001 0.016 0.021 0.035 0.001 0.016 0.021 Or Amount Affixed No of Pieces Pieces Subtotal Pound Rate 0.622 0.622 0.622 0.622 0.463 0.463 0.463 0.463 0.419 0.419 0.419 Pounds Pounds Subtotal Total For affixed postage mailings as described in DMM 243, compute and enter the rate for each piece in the Amount Affixed column, multiply by No. of Pieces and total in the Total column. Part A Total PS Form 3602-N, June 2007 (Page 2 of 11) Nonprofit Standard Mail Part B Automation Flats Check box at left if rates are populated in this section. Flats 3.3 oz. (0.2063 lbs.) or less Rate Entry Category B1 B2 B3 B4 B5 B6 B7 B8 B9 B10 B11 None None None None DBMC DBMC DBMC DBMC DSCF DSCF DSCF 5-Digit 3-Digit ADC Mixed ADC 5-Digit 3-Digit ADC Mixed ADC 5-Digit 3-Digit ADC Rate $0.212 0.269 0.301 0.354 0.179 0.236 0.268 0.321 0.170 0.227 0.259 No. of Pieces Total Flats Over 3.3 oz. up to 15.9984 oz. Entry B12 B13 B14 B15 B16 B17 B18 B19 B20 B21 B22 None None None None DBMC DBMC DBMC DBMC DSCF DSCF DSCF Rate Category 5-Digit 3-Digit ADC Mixed ADC 5-Digit 3-Digit ADC Mixed ADC 5-Digit 3-Digit ADC Piece Rate 0.086 0.143 0.175 0.228 0.086 0.143 0.175 0.228 0.086 0.143 0.175 Or Amount Affixed No of Pieces Pieces Subtotal Pound Rate 0.622 0.622 0.622 0.622 0.463 0.463 0.463 0.463 0.419 0.419 0.419 Pounds Pounds Subtotal Total For affixed postage mailings as described in DMM 343, compute and enter the rate for each piece in the Amount Affixed column, multiply by No. of Pieces and total in the Total column. Part B Total PS Form 3602-N3, June 2007 (Page 3 of 11) PSN 7530-07-000-6214 Nonprofit Standard Mail Part C Parcels Check box at left if rates are populated in this section. Machinable Parcels Entry C1 C2 C3 C4 C5 C6 C7 C8 None None None DBMC DBMC DSCF DDU Rate Category 5-Digit BMC Mixed BMC 5-Digit BMC 5-Digit 5-Digit Piece Rate 0.244 0.614 0.807 0.244 0.614 0.244 0244 0.050 Or Amount Affixed No of Pieces Pieces Subtotal Pound Rate 0.622 0.622 0.622 0.463 0.463 0.419 0.374 Pounds Pounds Subtotal Total Nonbarcoded Surcharge For affixed postage mailings as described in DMM 443, compute and enter the rate for each piece in the Amount Affixed column, multiply by No. of Pieces and total in the Total column. Part C Total Part D Nonautomation Letters Check box at left if rates are populated in this section. Machinable Letters 3.3 oz. (0.2063 lbs.) or less Rate Entry Rate Category D1 D2 D3 D4 D5 None None DBMC DBMC DSCF AADC Mixed AADC AADC Mixed AADC AADC $0.155 0.164 0.122 0.131 0.113 No. of Pieces Total Nonmachinable Letters 3.3 oz. (0.2063 lbs.) or less Rate Entry Rate Category D6 D7 D8 D9 D10 D11 D12 D13 D14 D15 D16 None None None None DBMC DBMC DBMC DBMC DSCF DSCF DSCF 5-Digit 3-Digit ADC Mixed ADC 5-Digit 3-Digit ADC Mixed ADC 5-Digit 3-Digit ADC 0.237 0.320 0.349 0.429 0.204 0.287 0.316 0.396 0.195 0.278 0.307 No. of Pieces Total Part D Total PS Form 3602-N, June 2007 (Page 4 of 11) Nonprofit Standard Mail Part E Nonautomation Flats Check box at left if rates are populated in this section. Flats 3.3 oz. (0.2063 lbs.) or less Rate Entry Category E1 E2 E3 E4 E5 E6 E7 E8 E9 E10 E11 None None None None DBMC DBMC DBMC DBMC DSCF DSCF DSCF 5-Digit 3-Digit ADC Mixed ADC 5-Digit 3-Digit ADC Mixed ADC 5-Digit 3-Digit ADC Rate $0.237 0.301 0.335 0.389 0.204 0.268 0.302 0.356 0.195 0.259 0.293 No. of Pieces Total Flats Over 3.3 oz. up to 15.9984 oz. Entry E12 E13 E14 E15 E16 E17 E18 E19 E20 E21 E22 None None None None DBMC DBMC DBMC DBMC DSCF DSCF DSCF Rate Category 5-Digit 3-Digit ADC Mixed ADC 5-Digit 3-Digit ADC Mixed ADC 5-Digit 3-Digit ADC Piece Rate 0.111 0.175 0.209 0.263 0.111 0.175 0.209 0.263 0.111 0.175 0.209 Or Amount Affixed No of Pieces Pieces Subtotal Pound Rate 0.622 0.622 0.622 0.622 0.463 0.463 0.463 0.463 0.419 0.419 0.419 Pounds Pounds Subtotal Total For affixed postage mailings as described in DMM 343, compute and enter the rate for each piece in the Amount Affixed column, multiply by No. of Pieces and total in the Total column. Part E Total PS Form 3602-N5, June 2007 (Page 5 of 11) PSN 7530-07-000-6215 Nonprofit Standard Mail Part F Irregular Parcels Check box at left if rates are populated in this section. Parcels 3.3 oz. (0.2063 lbs.) or less Rate Entry Category F1 F2 F3 F4 F5 F6 F7 F8 F9 F10 F11 F12 F13 None None None None DBMC DBMC DBMC DBMC DSCF DSCF DSCF DDU 5-Digit 3-Digit ADC Mixed ADC 5-Digit 3-Digit ADC Mixed ADC 5-Digit 3-Digit ADC 5-Digit Rate $0.481 0.527 0.788 1.003 0.448 0.494 0.755 0.970 0.439 0.485 0.746 0.430 0.050 No. of Pieces Total Nonbarcoded Surcharge Parcels Over 3.3 oz. up to 15.9984 oz. Entry F14 F15 F16 F17 F18 F19 F20 F21 F22 F23 F24 F25 F26 None None None None DBMC DBMC DBMC DBMC DSCF DSCF DSCF DDU Rate Category 5-Digit 3-Digit ADC Mixed ADC 5-Digit 3-Digit ADC Mixed ADC 5-Digit 3-Digit ADC 5-digit Piece Rate 0.355 0.401 0.662 0.877 0.355 0.401 0.662 0.877 0.355 0.401 0.662 0.355 0.050 Or Amount Affixed No of Pieces Pieces Subtotal Pound Rate 0.622 0.622 0.622 0.622 0.463 0.463 0.463 0.463 0.419 0.419 0.419 0.374 Pounds Pounds Subtotal Total Nonbarcoded Surcharge For affixed postage mailings as descbribed in DMM 443, compute and enter the rate for each piece in the Amount Affixed column, multiply by No. of Pieces and total in the Total column. Part F Total PS Form 3602-N, June 2007 (Page 6 of 11) Nonprofit Standard Mail Part G Not Flat-Machinable Check box at left if rates are populated in this section. Not Flat-Machinables 3.3 oz. (0.2063 lbs.) or less Rate Entry Rate Category G1 G2 G3 G4 G5 G6 G7 G8 G9 G10 G11 G12 G13 None None None None DBMC DBMC DBMC DBMC DSCF DSCF DSCF DDU 5-Digit 3-Digit ADC Mixed ADC 5-Digit 3-Digit ADC Mixed ADC 5-Digit 3-Digit ADC 5-Digit $0.334 0.380 0.641 0.902 0.301 0.347 0.608 0.869 0.292 0.338 0.599 0.283 0.050 No. of Pieces Total Nonbarcoded Surcharge Not Flat-Machinables Over 3.3 oz. up to 15.9984 oz. Entry G14 G15 G16 G17 G18 G19 G20 G21 G22 G23 G24 G25 G26 None None None None DBMC DBMC DBMC DBMC DSCF DSCF DSCF DDU Rate Category 5-Digit 3-Digit ADC Mixed ADC 5-Digit 3-Digit ADC Mixed ADC 5-Digit 3-Digit ADC 5-Digit Piece Rate 0.208 0.254 0.515 0.776 0.208 0.254 0.515 0.776 0.208 0.254 0.515 0.208 0.050 Or Amount Affixed No of Pieces Pieces Subtotal Pound Rate 0.622 0.622 0.622 0.622 0.463 0.463 0.463 0.463 0.419 0.419 0.419 0.374 Pounds Pounds Subtotal Total Nonbarcoded Surcharge For affixed postage mailings as described in DMM 443, compute and enter the rate for each piece in the Amount Affixed column, multiply by No. of Pieces and total in the Total column. Part G Total PS Form 3602-N7, June 2007 (Page 7 of 11) PSN 7530-07-000-6216 Nonprofit Standard Mail Part H Enhanced Carrier Route Letters Check box at left if rates are populated in this section. Letters 3.3 oz. (0.2063 lbs.) or less Rate Entry Category H1 H2 H3 H4 H5 H6 H7 H8 H9 None None None DBMC DBMC DBMC DSCF DSCF DSCF Saturation High Density Basic Saturation High Density Basic Saturation High Density Basic Rate $0.108 0.117 0.157 0.075 0.084 0.124 0.066 0.075 0.115 No. of Pieces Total Letters Over 3.3 oz. up to 3.5 oz.- Rate includes a discount that equals the nonletter piece rate minus the letter piece rate. Entry H10 H11 H12 H13 H14 H15 H16 H17 H18 None None None DBMC DBMC DBMC DSCF DSCF DSCF Rate Category Saturation High Density Basic Saturation High Density Basic Saturation High Density Basic Piece Rate 0.019 0.028 0.068 0.019 0.028 0.068 0.019 0.028 0.068 Or Amount Affixed No of Pieces Pieces Subtotal Pound Rate 0.432 0.432 0.432 0.273 0.273 0.273 0.229 0.229 0.229 Pounds Pounds Subtotal Total For affixed postage mailings as described in DMM 243, compute and enter the rate for each piece in the Amount Affixed column, multiply by No. of Pieces and total in the Total column. Part H Total PS Form 3602-N, June 2007 (Page 8 of 11) Nonprofit Standard Mail Part I Enhanced Carrier Route Flats Check box at left if rates are populated in this section. Flats 3.3 oz. (0.2063 lbs.) or less Rate Entry Category I1 I2 I3 I4 I5 I6 I7 I8 I9 I10 I11 I12 I13 None None None DBMC DBMC DBMC DSCF DSCF DSCF DDU DDU DDU Saturation High Density Basic Saturation High Density Basic Saturation High Density Basic Saturation High Density Basic Rate $0.118 0.136 0.180 0.085 0.103 0.147 0.076 0.094 0.138 0.067 0.085 0.129 0.015 No. of Pieces Total Detached Address Labels Flats Over 3.3 oz. up to 15.9984 oz. Entry I14 I15 I16 I17 I18 I19 I20 I21 I22 I23 I24 I25 I26 None None None DBMC DBMC DBMC DSCF DSCF DSCF DDU DDU DDU Rate Category Saturation High Density Basic Saturation High Density Basic Saturation High Density Basic Saturation High Density Basic Piece Rate 0.029 0.047 0.091 0.029 0.047 0.091 0.029 0.047 0.091 0.029 0.047 0.091 0.015 Or Amount Affixed No of Pieces Pieces Subtotal Pound Rate 0.432 0.432 0.432 0.273 0.273 0.273 0.229 0.229 0.229 0.184 0.184 0.184 Pounds Pounds Subtotal Total Detached Address Labels For affixed postage mailings as described in DMM 343, compute and enter the rate for each piece in the Amount Affixed column, multiply by No. of Pieces and total in the Total column. Part I Total PS Form 3602-N9, June 2007 (Page 9 of 11) PSN 7530-09-000-9938 Nonprofit Standard Mail Part J Enhanced Carrier Route Parcels Check box at left if rates are populated in this section. Parcels 3.3 oz. (0.2063 lbs.) or less Rate Entry Category J1 J2 J3 J4 J5 J6 J7 J8 J9 J10 J11 J12 J13 None None None DBMC DBMC DBMC DSCF DSCF DSCF DDU DDU DDU Saturation High Density Basic Saturation High Density Basic Saturation High Density Basic Saturation High Density Basic Rate $0.300 0.309 0.430 0.267 0.276 0.397 0.258 0.267 0.388 0.249 0.258 0.379 0.015 No. of Pieces Total Detached Address Labels Parcels Over 3.3 oz. up to 15.9984 oz. Entry J14 J15 J16 J17 J18 J19 J20 J21 J22 J23 J24 J25 J26 None None None DBMC DBMC DBMC DSCF DSCF DSCF DDU DDU DDU Rate Category Saturation High Density Basic Saturation High Density Basic Saturation High Density Basic Saturation High Density Basic Piece Rate 0.211 0.220 0.341 0.211 0.220 0.341 0.211 0.220 0.341 0.211 0.220 0.341 0.015 Or Amount Affixed No of Pieces Pieces Subtotal Pound Rate 0.432 0.432 0.432 0.273 0.273 0.273 0.229 0.229 0.229 0.184 0.184 0.184 Pounds Pounds Subtotal Total Detached Address Labels For affixed postage mailings as described in DMM 443, compute and enter the rate for each piece in the Amount Affixed column, multiply by No. of Pieces and total in the Total column. Part J Total PS Form 3602-N, June 2007 (Page 10 of 11) Nonprofit Standard Mail Part K Customized MarketMail Check box at left if rates are populated in this section. Pieces 3.3 oz. (0.2063 lbs.) or less. Rate K1 $0.334 No. of Pieces Total Part K Total Part L Repositionable Notes Check box at left if rates are populated in this section. Rate includes only charge for RPN, it does not include applicable postage charges. If using RPNs, all pieces in mailing must include RPNs. Rate Category L1 Letters and Flats Rate $0.015 No. of Pieces Total Part L Total Extra Services Part S Extra Service Check box at left if rates are populated in this section. Items mailed with Extra Services must meet the mailing standards for the extra service. Fee S1 S2 S3 S4 S5 S6 S7 S8 S9 S10 Return Receipt for Merchandise* S11 S12 S13 *parcels only No. of Pieces Total Delivery Confirmation (electronic only) Insurance (bulk only) Restricted Delivery 4.10 3.50 Part S Total PS Form 3602-N11, June 2007 (Page 11 of 11) PSN 7530-09-000-9939 Nonprofit Standard Mail — Instructions Use this form for Nonprofit Standard Mail rates. Step 1: Complete Mailer and Mailing sections on page 1. Step 2: Before you complete the Postage section, go to parts A through L and S. Complete the part(s) that pertain to your mailing. The following information will help you to determine which parts to complete: Parts A-C: Automation/Machinable Letters, Flats, and Parcels Part A: Automation rate letters. Enter total in Part A Total box. Part B: Automation rate flats. Enter total in Part B Total box. Part C: Machinable rate parcels. Enter total in Part C Total box. Parts D-F: Nonautomation/Nonmachinable Letters, Flats, and Parcels Part D: Part E: Part F: Nonautomation letters. Enter total in Part D Total box. Nonautomation flats. Enter total in Part E Total box. Irregular parcels. Enter total in Part F Total box. Parts G: Not Flat-Machinable Part G: Not Flat-Machinable pieces or nonmachinable letters paying NFM rates. Enter total in Part G Total box. Parts H-J: Enhanced Carrier Route Letters, Flats, and Parcels Part H: Part I: Part J: Enhanced carrier route letters. Enter total in Part H Total box. Enhanced carrier route flats or ECR letters paying flats rates. Enter total in Part I Total box.. Enhanced carrier route parcels. Enter total in Part J Total box. Part K: Customized MarketMail (CMM) - Enter total in Part K Total box. Part L: Repositionable Notes (RPN) - Enter total in Part L Total box. Part S: Extra Services - Enter total in Part S Total box. Step 3: Add the postage in parts A through S. For Permit Imprint mailings round off to four decimal places. For Postage Affixed round off to three decimal places. Once completed, return to the Postage section on page 1. Check the boxes that correspond to all applicable parts completed. Enter the Total Postage, rounded off to two decimal places. Step 4: Complete the line for Postage Affixed (if applicable). Check the box for the Rate at Which Postage Affixed (Correct, Lowest, or Neither). Multiply the number of pieces times the postage affixed. Put the total in the Postage Affixed block. Subtract the amount of Postage Affixed from the Total Postage and enter the remainder in Net Postage Due. Step 5: Read and sign the Certification section, including your telephone number. Attach all completed pages and submit with the mailing. Information: For more information on mailing standards, rates, and fees please go to Postal Explorer at pe.usps.com. PS Form 3602-NI, June 2007 (Instructions)