Docstoc

Postage Statement - Periodicals - One Issue or One Edition

Document Sample
Postage Statement - Periodicals - One Issue or One Edition Powered By Docstoc
					    United States Postal Service                                                                                                                      Post Office: Note Mail Arrival Date & Time
   Postage Statement — Periodicals                                                                                                                    (Do Not Round-Stamp)


   One Issue or One Edition
                Publication Title and Owner or News Agent's Name       Mailing Agent's (Printer or Consolidator) Name, Address, Telephone Number,                Entry Post Office Name, State, and ZIP+4
                                                                       and Email Address if Any
 Mailer




                 Customer No.                                          Printer/Consolidator Imprint Permit No.

                 CAPS Customer Ref. ID                                  Customer No.

                Applicable Parts Completed Statement for bundles/ Price Category          Regular      Nonprofit
                                                                                                                              Combined Mailing           Yes    Consolidated Postage Statement
                (select all that apply)    containers only
                     A        B-E       F  (If Applicable)             Classroom          Science-of-Agriculture                                         No              Yes             No
                Publication No.             Edition/Code          Mailing Date                      Processing Category              No. of Addressed Pieces     No. and Type of Containers
                                                                                                           Letters                                               (enter total number of containers)
Mailing




                Issue Date                    Issue Frequency         Statement Sequence No.               Flats
                                                                                                           Parcels
                Weight of a Single           Weight per Copy for Issue (Round off to 4 decimal Advertising Percentage in This                    Post Office Computed Weight per Copy (Round off to 4
                Ride-Along piece             places if necessary)                                Issue                                           decimal places if necessary)
                 0 . ___ ___ ___ ___ lb.         ____ ____ . ____ ____ ____ ____ pounds                ____ ____ . ____ ____ %                                   ____ ____ . ____ ____ ____ ____ pounds
                For Automation Price Pieces, Enter Date of           For Carrier Route Price Pieces, Enter Date of                               For Carrier Route Price Pieces, Enter Date of
                Address Matching and Coding                          Address Matching and Coding                                                 Carrier Route Sequencing

                    ____ ____ / ____ ____ / ____ ____ ____ ____                   ____ ____ / ____ ____ / ____ ____ ____ ____                                  ____ ____ / ____ ____ / ____ ____ ____ ____
                                                                                                Postmaster: Report total
                 Part A — In-County Prices                                                      Part A postage in AIC 224                        Total Part A (Page 2)

                 Part B — Outside County Pound Prices                                                Total Part B (Page 3)

                 Part C — Outside County Piece Prices                                               Total Part C (Page 4)

                 Part D — Outside County Bundle Prices                                              Total Part D (Page 5)

                 Part E — Outside County Sack/Tray/Pallet Prices                                    Total Part E (Page 6 &7)
Postage




                 Outside County Postage                                                   Subtotal Parts B, C, D, and E
                Preferred Price Discount - Nonprofit, Classroom, Limited Circulation, Limited Circulation Science of
                Agriculture (Add line B16, and parts C, D, and E Totals) _____ X .05 (all others enter zero)                                     —

                 Subtract the Preferred Price Discount from the Outside County Postage                                                           =
                 Part F — Outside County Ride-Along and Repositionable Notes (Page 8)                                                            +
                 Total Outside County Postage (Postmaster report in AIC 135)                                                                                                    =
                 Add Total Outside County Postage and Total Inside County Postage                                                                Total Postage
                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 prices 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.
Certification




                                                                                                      Privacy Notice: For information regarding our Privacy Policy visit www.usps.com.
                                                                  Name and Telephone Number of Contact                      USPS Employee's Signature                          Round Stamp (Required)
                                                                                                                                                                                              (Required)
                Owner or Agent's Name
                                                                  Person in Publisher's Office                                                                                 Date Mail Released
                                                                                                            USPS Use Only




                Owner or Agent's Signature                                                                                  Print USPS Employee's Name


                                                                                                                            Time

                                                                                                                                                                   AM
                                                                                                                                                                   PM




            PS Form 3541-1, May 2009 (Page 1 of 8) PSN 7530-07-000-6222                               This form and mailing standards are available on Postal Explorer at pe.usps.com.
Periodicals — One Issue or One Edition — In-County

       Part A                                                                               Check box at left if prices are populated in this section.
       In-County


Pound Price        Subscriber or        Nonsubscriber or
                    Requester            Nonrequester              Total                Total
       Entry         Copies                 Copies                Copies               Pounds                     Price                  Postage
 A1 DDU                                                                                                          $0.141

 A2 None                                                                                                          0.183

 A3                                                                              Total Pound Price Postage (Add lines A1 and A2)


Piece Price (Presort)
      Entry /                                                            Total         Addressed
                                   Presort Discount                                                               Price                  Postage
       Zone                                                             Copies          Pieces

 A4                Nonautomation                                                                                  0.130

 A5      Basic     Automation Letters                                                                             0.058

 A6                Automation Flats                                                                               0.114

 A7                Nonautomation                                                                                  0.118

 A8      3-Digit   Automation Letters                                                                             0.049

 A9                Automation Flats                                                                               0.106

 A10               Nonautomation                                                                                  0.105

 A11    5-Digit    Automation Letters                                                                             0.047

 A12               Automation Flats                                                                               0.099

 A13               Basic                                                                                          0.059
     Carrier
 A14               High Density                                                                                   0.044
     Route
 A15               Saturation                                                                                     0.030

 A16                       Presort Subtotal (Add lines A4-A15)

 A17 Number of Addressed Pieces at DDU Prices                                                                   $0.008


                                                              Piece Price Subtotal (A16 minus A17) A18



Ride-Along Price
(Must equal the number of copies in line A16,                            Total         Addressed
not number of addressed pieces)                                         Copies          Pieces                     Price                 Postage

 A19 Ride-Along Pieces                                                                                            0.165

Repositionable Notes
(Must equal the number of copies in line A16,                            Total         Addressed
not number of addressed pieces)                                         Copies          Pieces                     Price                 Postage

 A20 Repositionable Notes                                                                                         0.005



                                                             Other Subtotal(Add lines A19 and A20) A21


                                                           Part A Total (Add lines A3, A18, and A21)




PS Form 3541, May 2009 (Page 2 of 8)
Periodicals — One Issue or One Edition — Outside-County

       Part B                                                                                  Check box at left if prices are populated in this section.
       Outside-County - Pound Prices
For Nonprofit & Classroom: All commingled nonsubscriber or nonrequester copies over the 10% limit must pay regular prices & use a separate PS Form 3541.

Advertising Pound Prices
                Subscriber or  Nonsubsc. or Nonreq. Copies                                                                        Price
        Entry    Requester                                                Total            Total          Advertising
        Zone      Copies      W/In 10% Limit Over 10% Limit              Copies           Pounds           Pounds          Reg.      Sci/Ag   Postage
 B1     DDU                                                                                                                $0.131 $0.098

 B2 DSCF                                                                                                                   0.200     0.150

 B3 DADC                                                                                                                   0.212     0.159

 B4     1&2                                                                                                                0.237     0.178

 B5       3                                                                                                                     0.259

 B6       4                                                                                                                     0.317

 B7       5                                                                                                                     0.404

 B8       6                                                                                                                     0.496

 B9       7                                                                                                                     0.607

B10       8                                                                                                                     0.701

B11                                 Subtotal (Add lines B1-B10)



Nonadvertising Pound Prices
                        Total                    Advertising      equals        Nonadvertising X    Price
                                     minus                                                                                          Postage
                       Pounds                     Pounds                           Pounds        Reg Sci/Ag
B12       DDU                      (From B1)                     (From B1)                          0.109     0.109
B13       DSCF                     (From B2)                     (From B2)                          0.166     0.166

B14       DADC                     (From B3)                     (From B3)                          0.176     0.176

B15     All Others            (From B4-B10)                 (From B4-B10)                           0.197     0.197

B16                                                                                  Subtotal (Add lines B12-B15)



                                               Pound Price Postage Total (Add lines B11 and B16)

Nonadvertising Pound Prices - Alternate
(Nonprofit and Classroom publications with 10% or less advertising, or other publications with 0% advertising.)

                  Subscriber or
        Entry      Requester     Nonsubsc. or Nonreq. Copies              Total             Total            Price
        Zone        Copies      W/In 10% Limit Over 10% Limit            Copies            Pounds        Reg. Sci/Ag         Postage

 B12     DDU                                                                                            $0.109 $0.109

 B13     DSCF                                                                                             0.166    0.166

 B14     DADC                                                                                             0.176    0.176

 B15 All Others                                                                                           0.197    0.197

 B16                                                                                     Subtotal (Add lines B12-B15)



                                               Pound Price Postage Total (Add lines B11 and B16)

PS Form 3541-3, May 2009 (Page 3 of 8) PSN 7530-07-000-6223
Periodicals — One Issue or One Edition — Outside-County

      Part C                                                                         Check box at left if prices are populated in this section.
      Outside-County - Piece Prices
Machinable Flats                                                   Total       Addressed
          Level                      Price Level                  Copies        Pieces                    Price                  Postage

 C1       Mixed     Barcoded                                                                             $0.403

 C2       ADC       Nonbarcoded                                                                           0.435

 C3                 Barcoded                                                                              0.377
          ADC
 C4                 Nonbarcoded                                                                           0.400

 C5                 Barcoded                                                                              0.362
          3-Digit
 C6                 Nonbarcoded                                                                           0.383

 C7                 Barcoded                                                                              0.276
          5-Digit
 C8                 Nonbarcoded                                                                           0.286

Nonmachinable Flats and Parcels

 C9       Mixed     Barcoded (flats only)                                                                 0.561
          ADC
C10                 Nonbarcoded                                                                           0.606

C11                 Barcoded (flats only)                                                                 0.467
          ADC
C12                 Nonbarcoded                                                                           0.491

C13                 Barcoded (flats only)                                                                 0.407
          3-Digit
C14                 Nonbarcoded                                                                           0.417

C15                 Barcoded (flats only)                                                                 0.300
          5-Digit
C16                 Nonbarcoded                                                                           0.301

Letters

C17       Mixed     Barcoded                                                                              0.315

C18       ADC       Nonbarcoded                                                                           0.435

C19                 Barcoded                                                                              0.275
          ADC
C20                 Nonbarcoded                                                                           0.400

C21                 Barcoded                                                                              0.255
          3-Digit
C22                 Nonbarcoded                                                                           0.383

C23                 Barcoded                                                                              0.195
          5-Digit
C24                 Nonbarcoded                                                                           0.286

Carrier Route & Firm Bundles

C25 Basic                                                                                                 0.178

C26 High-Density                                                                                          0.151

C27 Saturation                                                                                            0.132

C28 Firm Bundle (Use "Addressed Pieces" to calculate postage)                                             0.178

C29                                 Subtotal (Add lines C1-C28)

C30 Nonadv. % (100 minus adv.%) _____ X # of Addressed Pieces (C29) X $0.00098


                                                                  Total (Line C29 minus C30)

PS Form 3541, May 2009 (Page 4 of 8)
Periodicals — One Issue or One Edition — Outside-County

      Part D                                                                Check box at left if prices are populated in this section.
      Outside-County - Bundle Prices


      Container
       Level                      Bundle Level                    Bundles                        Price                  Postage
 D1               Mixed ADC                                                                     $0.077

 D2               ADC                                                                            0.201
        Mixed
 D3               3-Digit/SCF                                                                    0.267
        ADC
 D4               5-Digit                                                                        0.276

 D5               Firm                                                                           0.179

 D6               ADC                                                                            0.111

 D7               3-Digit/SCF                                                                    0.183

 D8     ADC       5-Digit                                                                        0.199

 D9               Carrier Route                                                                  0.314
D10               Firm                                                                           0.149

D11               3-Digit/SCF                                                                    0.125

D12      SCF/     5-Digit                                                                        0.145

D13     3-Digit   Carrier Route                                                                  0.279

D14               Firm                                                                           0.137

D15               5-Digit                                                                        0.140
         CR/
D16               Carrier Route                                                                  0.147
        5-Digit
D17               Firm                                                                           0.077


                                Part D Total (Add lines D1-D17)




PS Form 3541-5, May 2009 (Page 5 of 8) PSN 7530-10-000-0501
Periodicals — One Issue or One Edition — Outside-County

      Part E                                                                Check box at left if prices are populated in this section.
      Outside-County - Sack and Tray Prices

Outside-County - Sack/Tray Prices

         Container Level                      Entry           Sacks/Trays                       Prices                  Postage
 E1                            Origin ADC                                                       $0.420
            Mixed ADC
 E2         Sack/Tray          Origin SCF                                                        0.420

 E3                            Origin Post Office/DMU                                            0.420
 E4                            Origin BMC                                                        2.010

 E5                            Origin ADC                                                        2.010

 E6                            Origin SCF                                                        2.010
          ADC Sack/Tray
 E7                            Origin Post Office/DMU                                            2.010
 E8                            Destination BMC                                                   1.400

 E9                            Destination ADC                                                   0.800

E10                            Origin BMC                                                        2.100

E11                            Origin ADC                                                        2.100

E12                            Origin SCF                                                        2.100
             3-Digit /
E13           SCF              Origin Post Office/DMU                                            2.100
            Sack/Tray
E14                            Destination BMC                                                   1.500

E15                            Destination ADC                                                   1.200
E16                            Destination SCF                                                   0.800

E17                            Origin BMC                                                        2.700

E18                            Origin ADC                                                        2.700

E19                            Origin SCF                                                        2.700

E20          5-Digit /         Origin Post Office/DMU                                            2.700
           Carrier Route
E21         Sack/Tray          Destination BMC                                                   2.000

E22                            Destination ADC                                                   1.700

E23                            Destination SCF                                                   1.300
E24                            DDU                                                               0.900


E25           Part E Sack and Tray Total (Add lines E1-E24)




PS Form 3541, May 2009 (Page 6 of 8)
Periodicals — One Issue or One Edition — Outside-County

      Part E - Continued                                                                Check box at left if prices are populated in this section.
      Outside-County - Pallet Prices

Outside-County - Pallet Prices

         Container Level                      Entry                         Pallets                         Prices                  Postage
E26                              Origin BMC                                                               $28.000

E27                              Origin ADC                                                                28.000

E28                              Origin SCF                                                                28.000
            ADC Pallet
E29                              Origin Post Office/DMU                                                    28.000
E30                              Destination BMC                                                           22.400

E31                              Destination ADC                                                           12.400

E32                              Origin BMC                                                                33.360

E33                              Origin ADC                                                                33.360

E34                              Origin SCF                                                                33.360
             3-Digit /
E35           SCF                Origin Post Office/DMU                                                    33.360
              Pallet
E36                              Destination BMC                                                           23.800

E37                              Destination ADC                                                           20.700

E38                              Destination SCF                                                           11.100

E39                              Origin BMC                                                                42.130

E40                              Origin ADC                                                                42.130

E41                              Origin SCF                                                                42.130

E42         5-Digit /            Origin Post Office/DMU                                                    42.130
          Carrier Route
E43          Pallet              Destination BMC                                                           31.900

E44                              Destination ADC                                                           30.200
E45                              Destination SCF                                                           20.400

E46                              DDU                                                                        1.600


E47                  Part E Pallet Total (Add lines E26-E46)



                                                          Part E Total (add lines E25 and E47)




PS Form 3541-7, May 2009 (Page 7 of 8) PSN: 7530-10-000-0502
Periodicals — One Issue or One Edition
     Part F
     Ride-Along Price and Repositionable Notes (Outside-County Only)                         Check box at left if prices are populated in this section.

Ride-Along Price                                                          Total         Addressed
(Must equal the number of copies, not number of addressed pieces)        Copies          Pieces
 F1 Ride-Along Pieces                                                                                             $0.165


Repositionable Notes                                                      Total         Addressed
(Must equal the number of copies, not number of addressed pieces)        Copies          Pieces
 F2 Repositionable Notes                                                                                           0.015


                                                                    Part F Total (Add lines F1 and F2)



 Instructions

Use this form for Periodicals mailings.
Step 1: Complete Mailer and Mailing sections on page 1 applicable to the mailing presented. For all sections not
applicable, Enter N/A.
Step 2: Before you complete the Postage section, go to parts A through E 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 prices.
    Parts B — Outside-County pound prices.
    Parts C — Outside-County piece prices.
    Parts D — Outside-County bundle prices.
    Parts E — Outside-County sack/tray/pallet prices.
    Parts F — Outside-County Ride-along and Repositionable Notes prices.
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. For outside-county sack/tray/pallet prices, complete distribution section
in order to determine Part E total. 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, prices, and fees please go to Postal Explorer at pe.usps.com.




PS Form 3541, May 2009 (Page 8 of 8)

				
DOCUMENT INFO
Shared By:
Categories:
Stats:
views:33
posted:7/24/2009
language:English
pages:8
Description: United States Postal Service Form Form may be out of date. To ensure you have the most up to date form, please visit: http://www.usps.com/forms/allforms.htm