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United States Postal Service Post Office: Note Mail Arrival Date & Time
(Do Not Round-Stamp)
Postage Statement—Periodicals
All Issues in a Calendar Month
Publication Title and Owner or News Agent's Mailing Agent's (Printer or Consolidator) Name, Address, Telephone Number, Entry Post Office Name, State, and
Name and Email Address If Any ZIP+4
Mailer
Customer No. Printer/Consolidator Permit No.
CAPS Cust. Ref. ID Customer No.
Applicable Parts Completed Price Category Regular Nonprofit No. and Type of Containers
(select all that apply) (enter total number of containers)
A B-E Classroom Science-of-Agriculture
Publication No. Edition/Code Month/Year First Issue Date Processing Category
Letters
Mailing
No. of Issues this Month Issue Frequency Statement Sequence No. Last Issue Date Flats
Parcels
Weight of One Sheet (Round off to 4 decimal Advertising Percentage in Total Combined Weight of One Copy from Each Issue
places if necessary) Month's Issue
___ ___ . ___ ___ ___ ___ pounds ___ ___ . ___ ___ % ___ ___ . ___ ___ ___ ___ pounds
For Automation Price Pieces, Enter Date of For Carrier Route Price Pieces, Enter Date of Address For Carrier Route Piece Prices, Enter Date of Carrier
Address Matching and Coding Matching and Coding Route Sequencing
___ ___ / ___ ___ / ___ ___ ___ ___ ___ ___ / ___ ___ / ___ ___ ___ ___ ___ ___ / ___ ___ / ___ ___ ___ ___
Postmaster: Report Total
Part A—In-County Prices Total Part A (Page 2)
Part A postage in AIC 224
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)
Postage
Part E—Outside County Sack/Tray/Pallet Prices Total Part E (Pages 6 & 7)
Outside County Postage Subtotal Parts B, C, D, and E
Preferred Price 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 Price 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
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.
Privacy Notice: For information regarding our Privacy Policy visit www.usps.com
Certification
Owner or Agent's Name Name and Telephone Number of USPS Employee's Signature Round Stamp (Required)
Contact 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-M1, May 2009 (Page 1 of 8) PSN 7530-05-000-4278 This form and mailing standards are available on Postal Explorer at pe.usps.com.
Periodicals—All Issues in a Calendar Month
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 Price Postage
Copies Copies Copies Pounds
A1 DDU $0.141
A2 None 0.183
A3 Total Pound Price Postage (Add lines A1 and A2)
Piece Price (Presort)
Entry / Average # Addressed
Presort Discount Price Postage
Zone of 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 Price 0.008
Piece Price Subtotal (A16 minus A17) A18
Part A Total (Add lines A3 and A18)
PS Form 3541-M, May 2009 (Page 2 of 8)
Periodicals—All Issues in a Calendar Month
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
Entry Requester Nonsubsc. or Nonreq. Copies Total Total Advertising Price
Postage
Zone Copies W/In10% Limit Over 10% Limit Copies Pounds Pounds Reg Sci/Ag
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 minus Advertising equals Nonadvertising X Price
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)
PS Form 3541-M3, May 2009 (Page 3 of 8) PSN 7530-10-000-0503
Periodicals—All Issues in a Calendar Month—Outside County
Part C Check box at left if prices are populated in this section.
Outside-County - Piece Prices
Machinable Flats
Average # Addressed
Level Presort Discount Price Postage
of Copies Pieces
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
C10 ADC 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-M, May 2009 (Page 4 of 8)
Periodicals—All Issues in a Calendar Month—Outside County
Part D Check box at left if prices are populated in this section.
Outside-County - Bundle Prices
Container
Bundle Level Average # of Bundles Price Postage
Level
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-M5, May 2009 (Page 5 of 8) PSN 7530-10-000-0504
Periodicals—All Issues in a Calendar Month—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 Average # Sacks/Trays Price Postage
E1 Origin ADC $0.420
Mixed ADC
E2 Origin SCF 0.420
Sack/Tray
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
Part E Sack and Tray Total
E25
(Add lines E1-E24)
PS Form 3541-M, May 2009 (Page 6 of 8)
Periodicals—All Issues in a Calendar Month—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 Average # Sacks/Trays Price 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-M7, May 2009 (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 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.
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 E.
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, prices, and fees please go to Postal Explorer at pe.usps.com.
PS Form 3541-M, May 2009 (Page 8 of 8)
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