United States Postal Service
Post Office: Note Mail Arrival Date & Time
Postage Statement — Package Services
(Bound Printed Matter, Library Mail, Media Mail, Parcel Post, and Parcel Select) Use this form for all Package Services. Only Library Mail and Media Mail may be combined.
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)
CAPS Cust. Ref. No. Customer No. Post Office of Mailing Type of Postage Permit #
Permit Imprint Metered
Customer No. Processing Category
Flats Parcels - Machinable Parcels - Nonmachinable
Customer No. Federal Agency Cost Code Statement Seq.No. Total Pieces pounds Total Weight
20 Pounds
Mailing Date Weight of a Single Piece
No. & Type of Containers ________ Sacks
____ ____ . ____ ____ ____ ____ Packaging Based on
Piece Count Weight Both
________ Flat Trays
If Sacked, Based on
Piece Count
For Barcoded Rate Pieces, Enter Date of Address Matching and Coding ____ ____ / ____ ____ / ____ ____ ____ ____ Parts Completed (Select all that apply)
________ Pallets
________ Other
A
B
C
D&E
S
Total Postage (Add parts totals)
Rate at Which Postage Affixed (Check one) Correct Lowest Neither
_________ pcs. x $ _____ . ______ =
Postage Affixed
Net Postage Due
For USPS Use Only: Additional Postage Payment (State reason)
(Subtract postage affixed from total postage)
(Add additional payment to net postage due and total in box for affixed or permit imprint - choose one only)
Postmaster: Report Total Postage in Applicable AIC (Permit imprint only)
Total Adjusted Postage Affixed
AIC 131 AIC 124 AIC 223
Total Adjusted BPM Postage Permit Imprint Total Adjusted Media Mail/Lib. Mail Postage Permit Imprint Total Adjusted Parcel Post/Select Postage Permit Imprint
The mailer's signature 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 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 ____ ____ . ____ ____ ____ ____ pounds Total Pieces Total Postage Presort Verification Performed? (Check One) Yes No Total Weight Round Stamp (Required) Name of Mailer or Agent Is figure at left adjusted from mailer's entries? If "Yes," Reason Yes No Telephone
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 Verifying Employee's Name
Contact
By (Initials) Time AM PM
PS Form
3605-R1, May 2007 (Page 1 of 10)
PSN 7530-08-000-3305
This form and mailing standards available on Postal Explorer at pe.usps.com.
Package Services
Bound Printed Matter
Part A
Check box at left if rates are populated in this section.
Nonpresorted - Flats or Parcels Barcoded / Zone Nonbarcoded A1 A2 A3 A4 A5 A6 A7 A8 A9 A10 A11 A12 A13 A14 1&2 3 4 5 6 7 8 1&2 3 4 5 6 7 8 Barcoded Barcoded Barcoded Barcoded Barcoded Barcoded Barcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded
Rate
No. of Pieces
Total
Carrier Route - Flats or Parcels Barcoded Zone Entry Nonbarcoded A15 1 & 2 None A16 A17 A18 A19 A20 A21 3 4 5 6 7 8 None None None None None None Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded
Piece Rate
Or Amount Affixed
No of Pieces
Pieces Subtotal
Pound Rate $0.122 0.148 0.195 0249 0.311 0.359 0.477 0.086 0.124 0.164 0.218 0.083 0.040
Pounds
Pounds Subtotal
Total
A22 1 & 2 DBMC Nonbarcoded A23 A24 A25 A26 A27 3 4 5 DBMC Nonbarcoded DBMC Nonbarcoded DBMC Nonbarcoded DSCF Nonbarcoded DDU Nonbarcoded
Part A Nonpresorted and Carrier Route BPM Total
PS Form 3605-R, May 2007 (Page 2 of 10)
Package Services
Bound Printed Matter
Part A cont.
Check box at left if rates are populated in this section.
Presorted - Flats or Parcels Zone Entry A28 1 & 2 None A29 A30 A31 A32 A33 A34 3 4 5 6 7 8 None None None None None None Barcoded Nonbarcoded Barcoded Barcoded Barcoded Barcoded Barcoded Barcoded Barcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Barcoded Barcoded Barcoded Barcoded Piece Rate Or Amount Affixed No of Pieces Pieces Subtotal Pound Rate $0.122 0.148 0.195 0.249 0.311 0.359 0.477 0.122 0.148 0.195 0.249 0.311 0.359 0.477 0.086 0.124 0.164 0.218 0.086 0.124 0.164 0.218 0.083 0.083 0.040 Pounds Pounds Subtotal Total
A35 1 & 2 None A36 A37 A38 A39 A40 A41 3 4 5 6 7 8 None None None None None None
A42 1 & 2 DBMC A43 A44 A45 3 4 5 DBMC DBMC DBMC
A46 1 & 2 DBMC Nonbarcoded A47 A48 A49 A50 A51 A52 3 4 5 DBMC Nonbarcoded DBMC Nonbarcoded DBMC Nonbarcoded DSCF Barcoded
DSCF Nonbarcoded DDU
Part A Presorted BPM Total
PS Form 3605-R3, May 2007 (Page 3 of 10)
PSN 7530-08-000-3306
Package Services
Library Mail and Media Mail
Part B
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Library Mail B1 B2 B3 B4 Basic Single Piece 5-Digit Basic
Barcoded / Nonbarcoded Barcoded Barcoded
Rate
No. of Pieces
Total
Nonbarcoded Nonbarcoded Barcoded / Nonbarcoded Barcoded Barcoded
B5 Single-Piece Media Mail B6 B7 B8 B9 Basic Single Piece 5-Digit Basic
Rate
No. of Pieces
Total
Nonbarcoded Nonbarcoded
B10 Single-Piece
Part B Total
PS Form 3605-R, May 2007 (Page 4 of 10)
Package Services
Parcel Select
Part C
Check box at left if rates are populated in this section.
Parcel Select Zone Entry C1 1 & 2 DBMC C2 C3 C4 3 4 5 DBMC DBMC DBMC
Machinable / Nonmachinable / Oversized Machinable Machinable Machinable Machinable Nonmachinable Nonmachinable Nonmachinable Nonmachinable Machinable Nonmachinable - 5-Digit Nonmachinable - 3-Digit Parcels Oversized Oversized Oversized Oversized Oversized Oversized
Rate
No. of Pieces
Total
C5 1 & 2 DBMC C6 C7 C8 C9 C10 C11 C12 3 4 5 DBMC DBMC DBMC DSCF DSCF DSCF DDU
C13 1 & 2 DBMC C14 C15 C16 C17 C18 3 4 5 DBMC DBMC DBMC DSCF DDU
Part C Total
PS Form 3605-R5, May 2007 (Page 5 of 10) PSN 7530-08-000-3307
Package Services
Single-Piece Parcel Post
Part D
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Single-Piece - Inter Barcoded / Inter Zone BMC/ASF Nonbarcoded D1 1 & 2 D2 D3 D4 D5 D6 D7 3 4 5 6 7 8 Inter Inter Inter Inter Inter Inter Inter Inter Inter Inter Inter Inter Inter Inter Inter Inter Inter Inter Inter Inter Inter Inter Inter Inter Inter Inter Inter Inter Barcoded Barcoded Barcoded Barcoded Barcoded Barcoded Barcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Machinable / Nonmachinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Nonmachinable Nonmachinable Nonmachinable Nonmachinable Nonmachinable Nonmachinable Nonmachinable Oversized Oversized Oversized Oversized Oversized Oversized Oversized Part D - Single-Piece Inter Total Rate No. of Pieces Total
D8 1 & 2 D9 D10 D11 D12 D13 D14 3 4 5 6 7 8
D15 1 & 2 D16 D17 D18 D19 D20 D21 3 4 5 6 7 8
D22 1 & 2 D23 D24 D25 D26 D27 D28 3 4 5 6 7 8
PS Form 3605-R, May 2007 (Page 6 of 10)
Package Services
Single-Piece Parcel Post
Part D cont.
Check box at left if rates are populated in this section.
Single-Piece - Intra Barcoded / Intra Zone BMC/ASF Nonbarcoded D29 Local D30 1 & 2 D31 D32 D33 3 4 5 Intra Intra Intra Intra Intra Intra Intra Intra Intra Intra Intra Intra Intra Intra Intra Intra Intra Intra Intra Intra Barcoded Barcoded Barcoded Barcoded Barcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Machinable / Nonmachinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Nonmachinable Nonmachinable Nonmachinable Nonmachinable Nonmachinable Oversized Oversized Oversized Oversized Oversized Rate No. of Pieces Total
D34 Local D35 1 & 2 D36 D37 D38 3 4 5
D39 Local D40 1 & 2 D41 D42 D43 3 4 5
D44 Local D45 1 & 2 D46 D47 D48 3 4 5
Part D - Single-Piece Intra Total
PS Form 3605-R7, May 2007 (Page 7 of 10) PSN 7530-08-000-3308
Package Services
Parcel Post
Part E
Check box at left if rates are populated in this section.
BMC Presort Zone E1 E2 E3 E4 E5 E6 E7 E8 E9 E10 E11 E12 E13 E14 E15 E16 E17 E18 E19 E20 E21 E22 E23 E24 E25 E26 E27 E28 1&2 3 4 5 6 7 8 1&2 3 4 5 6 7 8 1&2 3 4 5 6 7 8 1&2 3 4 5 6 7 8 Barcoded / Nonbarcoded Barcoded Barcoded Barcoded Barcoded Barcoded Barcoded Barcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Machinable / Nonmachinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Nonmachinable Nonmachinable Nonmachinable Nonmachinable Nonmachinable Nonmachinable Nonmachinable Oversized Oversized Oversized Oversized Oversized Oversized Oversized Rate No. of Pieces Total
Part E - BMC Presort Total
PS Form 3605-R, May 2007 (Page 8 of 10)
Package Services
Parcel Post
Part E cont.
Barcoded / Nonbarcoded Barcoded Barcoded Barcoded Barcoded Barcoded Barcoded Barcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Nonbarcoded Machinable / Nonmachinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Machinable Nonmachinable Nonmachinable Nonmachinable Nonmachinable Nonmachinable Nonmachinable Nonmachinable Oversized Oversized Oversized Oversized Oversized Oversized Oversized
Check box at left if rates are populated in this section.
OBMC Presort Zone E29 E30 E31 E32 E33 E34 E35 E36 E37 E38 E39 E40 E41 E42 E43 E44 E45 E46 E47 E48 E49 E50 E51 E52 E53 E54 E55 E56 1&2 3 4 5 6 7 8 1&2 3 4 5 6 7 8 1&2 3 4 5 6 7 8 1&2 3 4 5 6 7 8 Rate No. of Pieces Total
Part E - OBMC Presort Total
PS Form 3605-R9, May 2007 (Page 9 of 10) PSN 7530-09-000-9934
Extra Services
Extra Service Items mailed with Extra Services must meet the mailing standards for the extra service.
Part S
Check box at left if rates are populated in this section.
Fee S1 S2 S3 S4 S5 S6 S7 S8 S9 Restricted Delivery Return Receipt (Electronic) Return Receipt (Form 3811) 4.10 0.85 2.15 3.50 Collect on Delivery (COD) Delivery Confirmation (parcels only) Insurance Certificate of Mailing (3 or more) $0.35
No. of Pieces
Total
S10 Return Receipt for Merchandise S11 Signature Confirmation (parcels only) S12 Parcel Airlift (PAL) S13 Special Handling
Part S Total
PS Form 3605-R, May 2007 (Page 10 of 10)
Package Services - Instructions
Use this form for Package Services including Bound Printed Matter, Library Mail, Media Mail, Parcel Post, Parcel Select, and Parcel Return Service. Step 1: Complete Mailer and Mailing sections on page 1. Step 2: Determine which part(s) to complete for your mailing, as follows: Parts A - Bound Printed Matter (BPM) Flats or Parcels, Part B - Library Mail and Media Mail, Part C - Parcel Select, Part D & E - Parcel Post, or Part S - Extra Services. Step 3: Complete applicable part(s) as follows: Part A: Nonpresorted BPM is charged a per-piece rate based on weight and zone. Enter applicable per-piece rate in “Rate” column. Multiply per-piece rate times corresponding number of pieces and enter in “Total” column. Permit Imprint mailings, round off to four decimal places; Postage Affixed round off to three decimal places. Add line-item totals and enter sum in Part A Total box. Do not round. Presorted and Carrier Route BPM are charged a per-pound rate and a per-piece rate. Note: For pieces weighing one pound or less, calculate per-pound postage for a one pound piece. Permit Imprint: Check box to show if mailing Flats or Parcels; enter corresponding per-piece rate for all zones in column one. Multiply applicable per-piece rate times number of pieces per zone and enter in “Pieces Subtotal” column. Compute per-pound postage by multiplying the unrounded weight of a single piece (one pound per piece, minimum) times the number of pieces per zone; enter result in “No. of Pounds” column. Multiply the applicable Pound Rate times the number of pounds. Do not round. Enter result in “Total” column. Add line-item totals and enter sum in Part/Total box. Do not round. Postage Affixed: Check box to show if mailing Flats or Parcels. Compute per-pound postage by multiplying unrounded weight of a single piece (one pound per piece, minimum) times applicable Pound Rate for the zone. Do not round. Add per-pound postage to applicable per-piece postage. Round this number up to next tenth of a cent (three decimal places). Enter (rounded) postage amount in column one (“Amt. Affixed”) and multiply times corresponding number of pieces. Enter result in “Total” column. Add line-item totals and enter sum in Part/Total box. Do not round. Parts B-E: These categories of mail are charged a per-piece rate. Permit Imprint: Multiply number of pieces times applicable per-piece rate. Round each result off to four decimal places. Add the products and enter in “Total” column. Add line-item totals and enter sum in Part/Total box. Do not round. Postage Affixed: Compute applicable postage for a single piece. Round up to next tenth of a cent (three decimal places). Enter single-piece amount(s) in appropriate line in “Rate” column; multiply times corresponding number of pieces; enter result in “Total” column. Add line-item totals and enter sum in Part/Total box. Do not round. Part S: Extra Services are charged a per-piece rate. Permit Imprint: Multiply rate for requested extra service(s) times number of pieces. Enter result in “Total” column. Add the line-item totals and enter sum in Part S Total box. Round off to four decimal places. Add line-item totals and enter sum in Part A Total box. Do not round. Postage Affixed: Multiply rate for requested extra service(s) times number of pieces. Round off to three decimal places. Enter result in “Total” column. Add line-item totals and enter sum in Part S Total box. Do not round. Note: Add postage for extra services to individual postage amounts in Part A - D; round up sum to next tenth of a cent (three decimal places) and affix to piece(s); or include total postage for extra services in “Net Postage Due“ (p.1). Step 4: Go to Postage section on page 1. Place a check mark in the appropriate box(es) to show which part(s) you have completed. Add the postage from the Part/Total box for each completed section; round off to the nearest whole cent (two decimal places); enter sum in Total Postage. Step 5: Read and sign 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 3605-RI, May 2007 (Instructions) PSN 7530-10-000-0506