Check the boxes that correspond to the form parts used. Add the postage amounts for all parts and enter on Line 1 Subtotal Postage rounded off to two decimal places. United States Postal Service Post Office Note Mail Arrival Date Time Do Not Round-Stamp Postage Statement - Standard Mail Permit Holder s Name and Address and Email Address if Any Name and Address of Mail Owner If other than permit holder Mailer CAPS Cust. Total Adjusted Postage Affixed Postmaster Report Total Postage in AIC 130 AIC 208 Simplified Addressing EDDM Permit Imprint Only Incentive/Discount Claimed Type of Fee 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. 833 Part L Customized MarketMail Pieces 3. 3 oz. 02063 lbs. or less. L1 0. 440 Part L Total Part M Repositionable Notes Price includes only charge for RPN it does not include applicable postage charges. If using RPNs all pieces in mailing must include RPNs. Letters and Flats M1 Extra Services and Fees Part S Items mailed with Extra Services must meet the mailing standards for the extra service. S4 S17 S19 S25 S28 USPS Tracking Parcels only Picture Permit Imprint Certificate of Bulk Mailing Form 3606-D Live Animal Transportation Hazardous Material Transportation Pcs. Privacy Notice For information regarding our Privacy Policy visit www. usps. com. Signature of Mailer or Agent Printed Name of Mailer or Agent Signing Form Are postage figures at left adjusted from mailer s entries If yes reason Telephone USPS Employee s Signature Date Mailer Notified Contact By Initials Time AM PM To be completed in Presort Verification Performed If required No Check one I CERTIFY that this mailing has been inspected for each item below if required 1 eligibility for postage prices claimed 2 proper preparation and presort where required 3 proper completion of postage statement 4 payment of annual fee and 5 sufficient funds on deposit if required USPS Use Only Round Stamp Required Payment Date Total Postage non- PostalOne sites. pound F n/a Alternative Address Format OneCode ACS Multiple Pallets Other Alternative Method ACS This is Official Election Mail Parts Completed Select all that apply Certification NCOALink Ancillary Service Endorsement This is a Political Campaign Mailing No. and Type of Containers Sacks SSF Transaction For Mail Enclosed within Another Class Bound Printed Matter Mailer s Mailing Date Letters Flats Marketing Parcels Parcels - Machinable Parcels - Irregular CMM Catalogs Metered Mailing of Mailing Agent Print USPS Employee s Name PS Form 3602-R1 April 2016 Page 1 of 14 PSN 7530-07-000-6209 This form and mailing standards are available on Postal Explorer at pe. Further Information About Discount Total Column Mailings that qualify for Full Service Intelligent Mail Option will report the discount in the Discount Total column of each line of the postage statement. The Full Service Intelligent Mail Option lines are for display and data gathering purposes only. When there is a Full Service discount but no other incentive discount the Full Service discount is reported directly in the When there is both a Full Service discount and an incentive discount the Discount Total must include both discounts so it must be calculated in an offline calculation with the resulting value reported in the Discount Total column. The calculation is performed as follows by first determining the Full Service discount FSD by multiplying the number of Full Service pieces by the per-piece Full Service discount. Then you must calculate the Incentive Discount ID by subtracting the Full Service discount FSD from form such as. 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 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. Signature of Mailer or Agent Printed Name of Mailer or Agent Signing Form Are postage figures at left adjusted from mailer s entries If yes reason Telephone USPS Employee s Signature Date Mailer Notified Contact By Initials Time AM PM To be completed in Presort Verification Performed If required No Check one I CERTIFY that this mailing has been inspected for each item below if required 1 eligibility for postage prices claimed 2 proper preparation and presort where required 3 proper completion of postage statement 4 payment of annual fee and 5 sufficient funds on deposit if required USPS Use Only Round Stamp Required Payment Date Total Postage non- PostalOne sites. Pound F n/a Alternative Address Format OneCode ACS Multiple Pallets Other Alternative Method ACS This is Official Election Mail Parts Completed Select all that apply Certification NCOALink Ancillary Service Endorsement This is a Political Campaign Mailing No. and Type of Containers Sacks SSF Transaction For Mail Enclosed within Another Class Bound Printed Matter Mailer s Mailing Date Letters Flats Marketing Parcels Parcels - Machinable Parcels - Irregular CMM Catalogs Metered Mailing of Mailing Agent Print USPS Employee s Name PS Form 3602-R1 April 2016 Page 1 of 14 PSN 7530-07-000-6209 This form and mailing standards are available on Postal Explorer at pe. usps. com. Standard Mail Part A Check box at left if prices are populated in this section. Automation Letters Letters 3.
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