Name and Address of Mailing Agent (If other than permit holder) CRID CRID CRID. Weight of a Single Piece. M-Bags

Transcription

1 DRAFT United States Postal Postage Statement International Mail Post Office: Note Mail Arrival Date & Time (Do Not Round-Stamp) Mailing Mailer Postage Use this form for all International Mailings. Only one part may be completed per mailing. Permit Holder's Name and Address and Address, if Any Post Office of Mailing Type of Postage Meter Permit Imprint Precanceled Stamps Partial Permit Imprint Permit # 1 Telephone CAPS Cust. Ref. No. Name and Address of Mailing Agent (If other than permit holder) Mailer's Mailing Date Telephone Name and Address of Mail Owner (If other than permit holder) CRID CRID CRID Parts Completed (Select One) : Canada Admail Only Category (Check One) Standard Of total pcs., # of Large USPS-Supplied GXG Legal-Size (For Part A, C, D only) Envs. (Part H Only) Letters Flats Packages Federal Agency Cost Code Statement Seq. No. No. & Type of Containers Postage (Add parts s) at Which Postage Affixed (Check one). Complete if mailing includes pieces bearing metered or precanceled stamps. Correct Lowest Neither pcs. x $. = Postage Affixed Incentive/Discount Flat Dollar Amount Flat Dollar Amount Permit # Net Postage Due (Line 1 +/- Lines 2, 3, 4) For USPS Use Only: Additional Postage Payment (State reason) Weight of a Single Piece. M-Bags A B C D E F G H P Weight (Less Tare) Check box if mailing is under an ICM Agreement and enter ICM Agreement No. (if applicable) Receipt No. Tare Weight Direct ment (Specify Country) Tier (Select One): N/A Com Base Com Plus GEPS Select if any extra services are included: Mixed (C & D only) Q R S Sacks Trays Flat Trays Pallets Other Certification For postage affixed, add additional payment to net postage due; for permit imprint, add additional payment to total postage. Permit Imprint Only Check One Report in AIC: AIC 234 (ISAL) AIC 245 (M-Bag Airmail) AIC 235 (IPA) AIC 246 (Global Direct, Comm epacket) AIC 243 (FCMI, FCPIS) AIC 244 (PMI, PMEI, GXG) Adjusted Postage Affixed Adjusted Postage Permit Imprint Incentive/ Discount Claimed: Type of : The mailer's signature certifies acceptance by the Mailer 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 the mailing qualifies for the prices and fees claimed; and this mailing does not contain any dangerous articles, or articles prohibited by legislation or by postal or customs regulations. The mailer hereby certifies that this mailing is in compliance with all applicable export laws, regulations, or orders and certifies that the mailer has provided any necessary documentation required by the USPS, the U.S. Government, or destination country foreign government, or other authority. See the International Mail Manual for additional information. The mailer agrees to indemnify the United States Postal from any and all claims, losses, costs, damages or expenses incurred by USPS as a result of mailer's failure to comply with any applicable laws or regulations. The mailer understands 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 Signature of Mailer or Agent Printed Name of Mailer or Agent Signing Form Telephone USPS Use Only To be completed in non- PostalOne! sites Weight of a Single Piece Postage Weight Presort Verification Performed? (If required) Yes No 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 Employee's Signature Are postage figures at left adjusted from mailer's entries? If yes, reason: Yes No Date Mailer Notified Print USPS Employee's Name Contact By (Initials) Time AM PM Round Stamp (Required) Payment Date USPS Use Only To be completed in non-postalone! sites PS Form , January 2016 (Page 1 of 17) PSN This form and mailing standards are available on Postal Explorer at pe.usps.com.

2 First-Class Mail International Permit Imprint Part A First-Class Mail International Postcards Destination Country Per Piece Postage Discount Postage A1 A2 Canada/Mexico All Other Countries Letters (up to 3.5 ounces) and Flats (up to 4 pounds) Destination Country/ Group Per Piece Postage Discount Postage A3 1 (Canada) A4 2 (Mexico) A5 3 A6 4 A7 5 A8 6 A9 7 A10 8 A11 9 Nonmachinable A12 Surcharge (letters only, up to 3.5 ounces) M-Bag Airmail Group A13 1 No. Sacks per Sack Sack lbs. of All Sacks Over 11 lbs. Per Pound Pound Postage Discount Postage A14 2 A15 3 A16 4 A17 5 A18 6 A19 7 A20 8 A21 9 A22 (add lines A1-A21) ICM Incentive (if applicable) % Incentive Postage (A22) Postage Incentive A23 Incentive Percentage = X = - Part A (line A22 minus A23) PS Form 3700, January 2016 (Page 2 of 17)

3 First-Class Package International Permit Imprint Part B First-Class Package International - Com Base, Com Plus, GEPS/NSA Packages/Small Packets (up to 4 pounds) Destination Country/ Group Per Piece Postage Discount Postage B1 1 (Canada) B2 2 (Mexico) B3 3 B4 4 B5 5 B6 6 B7 7 B8 8 B9 9 Part B (Add lines B1-B9) PS Form , January 2016 (Page 3 of 17) PSN

4 International Surface Air Lift ISAL - Permit Imprint Part C International Surface Air Lift-ISAL Postcards/Letters, Flats and Packages (Small Packets) Group Category C1 WW* Mixed C2 15 Direct C3 15 Mixed C4 16 Direct C5 16 Mixed C6 17 Direct C7 17 Mixed C8 18 Direct C9 18 Mixed C10 19 Direct C11 19 Mixed Piece Pounds ISC Drop Pounds Discount Postage Piece & Pounds Postage * Worldwide Nonpresort Postcards/Letters (up to 3.5 ounces) Group Category C12 1 Direct C13 2 Direct C14 3 Direct C15 4 Direct C16 5 Direct C17 6 Direct C18 7 Direct C19 8 Direct C20 9 Direct C21 9 Mixed C22 10 Direct C23 10 Mixed C24 11 Direct C25 11 Mixed C26 12 Direct C27 12 Mixed C28 13 Direct C29 13 Mixed C30 14 Direct C31 14 Mixed Piece Pounds ISC Drop Pounds Discount Postage Piece & Pounds Postage PS Form 3700, January 2016 (Page 4 of 17) Part C continued on next page

5 International Surface Air Lift ISAL - Permit Imprint Part C - Continued International Surface Air Lift-ISAL Flats (up to 17.6 ounces) Group Category C32 1 Direct C33 2 Direct C34 3 Direct C35 4 Direct C36 5 Direct C37 6 Direct C38 7 Direct C39 8 Direct C40 9 Direct C41 9 Mixed C42 10 Direct C43 10 Mixed C44 11 Direct C45 11 Mixed C46 12 Direct C47 12 Mixed C48 13 Direct C49 13 Mixed C50 14 Direct C51 14 Mixed Piece Pounds ISC Drop Pounds Discount Postage Piece & Pounds Postage Packages (Small Packets) (up to 4.4 pounds) Group Category C52 1 Direct C53 2 Direct C54 3 Direct C55 4 Direct C56 5 Direct C57 6 Direct C58 7 Direct C59 8 Direct C60 9 Direct C61 9 Mixed C62 10 Direct C63 10 Mixed C64 11 Direct C65 11 Mixed C66 12 Direct C67 12 Mixed C68 13 Direct C69 13 Mixed C70 14 Direct C71 14 Mixed Piece Pounds ISC Drop Pounds Discount Postage Piece & Pounds Postage C72 PS Form , January 2016 (Page 5 of 17) PSN (add lines C1-C71) Part C continued on next page

6 International Surface Air Lift ISAL - Permit Imprint Part C - Continued International Surface Air Lift-ISAL International Surface Air Lift-M-Bag-ISAL Group C73 1 C74 2 C75 3 C76 4 C77 5 C78 6 C79 7 C80 8 C81 9 C82 10 C83 11 C84 12 C85 13 C86 14 C87 15 C88 16 C89 17 C90 18 C91 19 No. Sacks ISC Drop Sacks lbs. of All Sacks over 11 lbs. ISC Drop lbs. of Any ISC Sack Less Than 11 lbs. ISC Drop 5-11 lb. Incentive Lbs. Discount Postage Postage C92 (add lines C72 and C73-C91) ICM Incentive (if applicable) % Incentive Postage (C92) C93 Incentive Percentage = X = - Part C (line C92 minus C93) PS Form 3700, January 2016 (Page 6 of 17)

7 International Priority Airmail IPA - Permit Imprint Part D International Priority Airmail-IPA Postcards/Letters, Flats and Packages (Small Packets) Group Category D1 WW* Mixed D2 15 Direct D3 15 Mixed D4 16 Direct D5 16 Mixed D6 17 Direct D7 17 Mixed D8 18 Direct D9 18 Mixed D10 19 Direct D11 19 Mixed Piece Pounds ISC Drop Pounds Discount Postage Piece & Pounds Postage * Worldwide Nonpresort Postcards/Letters (up to 3.5 ounces) Group Category D12 1 Direct D13 2 Direct D14 3 Direct D15 4 Direct D16 5 Direct D17 6 Direct D18 7 Direct D19 8 Direct D20 9 Direct D21 9 Mixed D22 10 Direct D23 10 Mixed D24 11 Direct D25 11 Mixed D26 12 Direct D27 12 Mixed D28 13 Direct D29 13 Mixed D30 14 Direct D31 14 Mixed Piece Pounds ISC Drop Pounds Discount Postage Piece & Pounds Postage Part D continued on next page PS Form , January 2016 (Page 7 of 17) PSN

8 International Priority Airmail IPA - Permit Imprint Part D - Continued International Priority Airmail-IPA Flats (up to 17.6 ounces) Group Category D32 1 Direct D33 2 Direct D34 3 Direct D35 4 Direct D36 5 Direct D37 6 Direct D38 7 Direct D39 8 Direct D40 9 Direct D41 9 Mixed D42 10 Direct D43 10 Mixed D44 11 Direct D45 11 Mixed D46 12 Direct D47 12 Mixed D48 13 Direct D49 13 Mixed D50 14 Direct D51 14 Mixed Piece Pounds ISC Drop Pounds Discount Postage Piece & Pounds Postage Packages (Small Packets) (up to 4.4 pounds) Group Category D52 1 Direct D53 2 Direct D54 3 Direct D55 4 Direct D56 5 Direct D57 6 Direct D58 7 Direct D59 8 Direct D60 9 Direct D61 9 Mixed D62 10 Direct D63 10 Mixed D64 11 Direct D65 11 Mixed D66 12 Direct D67 12 Mixed D68 13 Direct D69 13 Mixed D70 14 Direct D71 14 Mixed Piece Pounds ISC Drop Pounds Discount Postage Piece & Pounds Postage D72 PS Form 3700, January 2016 (Page 8 of 17) (add lines D1-D71) Part D continued on next page

9 International Priority Airmail IPA - Permit Imprint Part D - Continued International Priority Airmail-IPA International Priority Airmail-M-Bag-IPA Group D73 1 D74 2 D75 3 D76 4 D77 5 D78 6 D79 7 D80 8 D81 9 D82 10 D83 11 D84 12 D85 13 D86 14 D87 15 D88 16 D89 17 D90 18 D91 19 No. Sacks ISC Drop Sacks lbs. of All Sacks over 11 lbs. ISC Drop lbs. of Any ISC Sack Less Than 11 lbs. ISC Drop 5-11 lb. Incentive Lbs. Discount Postage Postage D92 (add lines D72 and D73-D91) ICM Incentive (if applicable) % Incentive Postage (D92) D93 Incentive Percentage = X = - Part D (line D92 minus D93) PS Form , January 2016 (Page 9 of 17) PSN

10 Priority Mail International - Permit Imprint- Transmits Customs Data Part E Priority Mail International - Com Base, Com Plus, GEPS/NSA Priority Mail International Group Pounds E1 E2 E3 1 - Montreal 1 - Toronto 1 - Vancouver E4 2 E5 3 E6 4 E7 5 E8 6 E9 7 E10 8 E11 9 E12 10 E13 11 E14 12 E15 13 E16 14 E17 15 E18 16 E19 17 Postage Discount Postage Flat Rate Envelopes (Individual Weight Limit: 4 lbs.) (15" x 9 1/2" or Smaller USPS-Produced) Per Piece Discount Postage Postage E20 Group 1 E21 Group 2 E22 Group 3 E23 Group 4 E24 Group 5 E25 Group 6 E26 Group 7 E27 Group 8 E28 Group 9 E29 Group 10 PS Form 3700, January 2016 (Page 10 of 17) Part E continued on next page

11 Priority Mail International - Permit Imprint- Transmits Customs Data Part E - Continued Priority Mail International - Com Base, Com Plus, GEPS/NSA Padded Flat Rate Envelopes (Individual Weight Limit: 4 lbs.) Per Piece Postage Discount Postage E30 Group 1 E31 Group 2 E32 Group 3 E33 Group 4 E34 Group 5 E35 Group 6 E36 Group 7 E37 Group 8 E38 Group 9 E39 Group 10 Small Flat Rate Boxes (Individual Weight Limit: 4 lbs.) (Including items O-Small FRBX, ODVDS, and O-1096-L) Per Piece Postage Discount Postage E40 Group 1 E41 Group 2 E42 Group 3 E43 Group 4 E44 Group 5 E45 Group 6 E46 Group 7 E47 Group 8 E48 Group 9 E49 Group 10 Medium Flat Rate Boxes (Individual Weight Limit: 20 lbs.) Per Piece Postage Discount Postage E50 Group 1 E51 Group 2 E52 Group 3 E53 Group 4 E54 Group 5 E55 Group 6 E56 Group 7 E57 Group 8 E58 Group 9 E59 Group 10 PS Form , January 2016 (Page 11 of 17) PSN Part E continued on next page

12 Priority Mail International - Permit Imprint- Transmits Customs Data Part E - Continued Priority Mail International - Com Base, Com Plus, GEPS/NSA Large Flat Rate Boxes (Individual Weight Limit: 20 lbs.) Per Piece Postage Discount Postage E60 Group 1 E61 Group 2 E62 Group 3 E63 Group 4 E64 Group 5 E65 Group 6 E66 Group 7 E67 Group 8 E68 Group 9 E69 Group 10 Part E (Add lines E1 - E69) Priority Mail International - Regional Rate Box - Transmits Customs Data Part F Priority Mail International - Regional Rate Box* - NSA Box A (Maximum Weight 10 lbs.) F1 Group 1 No.of Postage Discount Postage F2 Group 2 F3 Group 3 F4 Group 4 F5 Group 5 F6 Group 6 F7 Group 7 F8 Group 8 F9 Group 9 F10 Group 10 Box B (Maximum Weight 20 lbs.) F11 Group 1 No.of Postage Discount Postage F12 Group 2 F13 Group 3 F14 Group 4 F15 Group 5 F16 Group 6 F17 Group 7 F18 Group 8 F19 Group 9 F20 Group 10 Part F (Add lines F1 - F20) PS Form 3700, January 2016 (Page 12 of 17)

13 Priority Mail Express International - Permit Imprint - Transmits Customs Data Part G Priority Mail Express International - Com Base, Com Plus, GEPS/NSA Priority Mail Express International Group Pounds G1 1 G2 2 G3 3 G4 4 G5 5 G6 6 G7 7 G8 8 G9 9 G10 10 G11 11 G12 12 G13 13 G14 14 G15 15 G16 16 G17 17 Postage Discount Postage Flat Rate Envelope (Individual Weight Limit: 4 lbs.) (12 1/2" x 9 1/2") (EP 13 - F) Per Piece Postage Discount Postage G18 Group 1 G19 Group 2 G20 Group 3 G21 Group 4 G22 Group 5 G23 Group 6 G24 Group 7 G25 Group 8 Padded Flat Rate Envelope (Individual Weight Limit: 4 lbs.) (12 1/2" x 9 1/2") (EP 13 - PE) Per Piece Postage Discount Postage G26 Group 1 G27 Group 2 G28 Group 3 G29 Group 4 G30 Group 5 G31 Group 6 G32 Group 7 G33 Group 8 PS Form , January 2016 (Page 13 of 17) PSN

14 Priority Mail Express International - Permit Imprint - Transmits Customs Data Part G - Continued Priority Mail Express International - Com Base, Com Plus, GEPS/NSA Legal Flat Rate Envelope (Individual Weight Limit: 4 lbs.) (15" x 9 1/2") (EP 13 - L) Per Piece Postage Discount Postage G34 Group 1 G35 Group 2 G36 Group 3 G37 Group 4 G38 Group 5 G39 Group 6 G40 Group 7 G41 Group 8 Part G (Add lines G1 - G41) Global Express Guaranteed (GXG) - Permit Imprint - Transmits Customs Data Part H Global Express Guaranteed (GXG) - Com Base, Com Plus, GEPS/NSA Global Express Guaranteed (GXG) Group Pounds H1 1 (Canada) H2 2 (Mexico) H3 3 H4 4 H5 5 H6 6 H7 7 H8 8 Postage Discount Postage Part H (Add lines H1 - H8) PS Form 3700, January 2016 (Page 14 of 17)

15 Commercial epacket Permit Imprint Transmits Customs Data Part P Commercial epacket - NSA Commercial epacket Group P1 1 P2 2 P3 3 P4 4 P5 5 P6 6 P7 7 P8 8 P9 9 P10 10 P11 11 P12 12 P13 13 P14 14 P15 15 Piece Pounds Pounds Pounds Postage Discount Piece & Pound Postage Part P (Add lines P1 - P15) PS Form , January 2016 (Page 15 of 17) PSN

16 Global Direct Permit Imprint Part Q Global Direct Global Direct Destination Country & Product Weight Postage Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 Q10 Q11 Q12 Q13 Q14 Reserved Part R Reserved Destination Country & Product Weight Postage R1 R2 R3 R4 R5 R6 R7 R8 R9 R10 R11 R12 R13 R14 PS Form 3700, January 2016 (Page 16 of 17)

17 International Extra s and s Part S Extra s Postage Discount Postage S1 Certificate of Mailing (3 or more - Form 3877) S5 Insurance S6 Registered Mail S9 Return Receipt (Form 2865) S17 Picture Permit Imprint S19 Certificate of Bulk Mailing (Form 3606) Part S (add lines S1 - S19) PS Form , January 2016 (Page 17 of 17) PSN

18 International Mail Instructions Use this form for all International mailings. Step 1: Complete Mailer and Mailing sections on page 1. The Mailer section must be completely filled in, including the Permit Holder in the first box, the Mailing Agent, if any as described below, in the second box, and the Mail Owner, as described below, if other than the Permit Holder, in the third box. Mailing Agent: The mailing agent is a business entity, organization, or individual acting on behalf of one or more mail owners by providing mailing services for which the mail owners compensate the mailing agent. A business entity, organization, or individual whose services define it as a mailing agent may also be considered a mail owner, but only for its own mail or the mail of its subsidiaries. Mailing agents include, but are not limited to the following: Printer, letter shop, address list provider/manager; mail preparer, postage payment provider, mailing logistics provider, mailing tracking provider, ad agency, and mailing information manager. Mail Owner: The mail owner is the business entity, organization, or individual who makes business decisions regarding the mailpiece content, directly benefits from the mailing, and ultimately pays for postage on the mailpiece directly or by way of a mailing agent. Step 2: Determine applicable part(s) A through S to complete for your mailing. Part A - First-Class Mail International (FCMI) including Airmail M-Bags Part B - First-Class Package International (FCPIS) Part C - International Surface Air Lift (ISAL) including ISAL M-Bags Part D - International Priority Airmail (IPA) including IPA M-Bags Part E - Priority Mail International (PMI) - Transmits Customs Data Part F - Priority Mail International - Regional Rate Box Part G - Priority Mail Express International (PMEI) - Transmits Customs Data Part H - Global Express Guaranteed (GXG) - Transmits Customs Data Part P - Commercial epacket - Transmits Customs Data Part Q - Global Direct Part R - Reserved Part S - Extra s and s Step 3: Complete only applicable part(s), enter sum of the (unrounded) postage amounts for that part. Step 4: Return to the Postage section on page 1. Check the boxes that correspond to the form parts used. Add the postage amounts for all parts and enter on Line 1 Postage, rounded off to two decimal places. Step 5: Complete Line 2 for Postage Affixed mailings. Check the applicable box (Correct, Lowest, or Neither) for the at which Postage is Affixed. Multiply the number of pieces by the postage affixed. Put the total in the Postage Affixed block. Step 6: Enter any Incentive/Discount Flat Amount on Line 3 and any Flat Dollar Amount on Line 4. Step 7: Calculate Line 5 Net Postage Due by subtracting any Postage Affixed (Line 2) from the Postage (Line 1), subtracting and Incentive/Discount (Line 3), and adding any (Line 4). For permit imprint mailings, the Net Postage Due is the amount that will be withdrawn from the permit imprint account listed in the Permit # box in the Mailing section. For postage affixed mailings, the Net Postage Due is the amount that must be tendered in addition to that already affixed to the mail, and it may be tendered by any of the applicable methods including withdrawal from an advance deposit account that can be listed by Permit # on Line 5. Step 8: Read and sign the Certification section, including your telephone number. Attach all completed pages and submit with the mailing. Postmaster: Report permit imprint revenues using Account Identifier Codes (AIC) as follows: Part A - AIC 243 First-Class Mail International (FCMI) AIC 245 Airmail M-Bags Part B - AIC 243 First-Class Package International (FCPIS) Part C - AIC 234 ISAL (including ISAL M-Bags) Part D - AIC 235 IPA (including IPA M-Bags) Parts E, F, G, & H - AIC 244 Priority Mail International (PMI), PMI Regional Rate Box, Priority Mail Express International (PMEI), and Global Express Guaranteed (GXG) Parts P& Q - AIC 246 Commercial epacket and Global Direct PS Form 3700, January 2016 (Instructions)