Total Postage (Add parts totals)

Transcription

1 United States Postal Service 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 Address If Any Telephone Name and Address of Mailing Agent (If other than permit holder) Telephone Post Office: Note Mail Arrival Date & Time 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 Imprint Metered Rate at Which Postage Affixed (Check one) Correct Lowest Neither Processing Category Flats Parcels - Parcels - Permit # Packaging Based on For Rate Pieces, Enter Date of Address Matching and Coding / / Parts Completed (Select all that apply) Net Postage Due Customer No. Mailing Date Weight of a Single Piece. pounds Piece Count Weight Both Piece Count 20 Pounds A If Sacked, Based on B C D & E S pcs. x $. = Federal Agency Cost Code Customer No. Statement Seq.No. Total Postage (Add parts totals) (Subtract postage affixed from total postage) Total Pieces Total Weight Postage Affixed No. & Type of Containers Sacks Flat Trays Pallets Other For USPS Use Only: Additional Postage Payment (State reason) (Add additional payment to net postage due and total in box for affixed or permit imprint - choose one only) Postmaster: AIC 11 Report Total Postage in Applicable AIC AIC 12 (Permit imprint only) AIC 22 Total Adjusted Postage Affixed 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 Signature of Mailer or Agent Name of Mailer or Agent Telephone Weight of a Single Piece. pounds Is figure at left adjusted from mailer's entries? If "Yes," Reason Yes No Total Pieces Total Weight Total Postage Round Stamp (Required) Presort Verification Performed? (Check One) Yes No I CERTIFY that this mailing has been inspected concerning: (1) eligibility for postage rates claimed; (2) proper preparation (and presort where required); () proper completion of postage statement; and () payment of annual fee (if required). Date Mailer Notified Contact By (Initials) Verifying Employee's Signature Verifying Employee's Name Time AM PM PS Form 0-R1, May 200 (Page 1 of 10) PSN This form and mailing standards available on Postal Explorer at pe.usps.com.

2 Part A Bound Printed Matter Nonpresorted - Flats or Parcels / A1 Rate No. of Pieces Total A2 A A A A A A A9 A10 A11 A12 A1 A1 Carrier Route - Flats or Parcels Entry Piece Rate Or Amount Affixed No of Pieces Pieces Subtotal Pound Rate Pounds Pounds Subtotal Total A1 None $0.122 A1 None 0.1 A1 None 0.19 A1 None 029 A19 None 0.11 A20 None 0.9 A21 None 0. A A A2 0.1 A A2 DSCF 0.0 A2 DDU 0.00 Part A Nonpresorted and Carrier Route BPM Total PS Form 0-R, May 200 (Page 2 of 10)

3 Part A cont. Bound Printed Matter Presorted - Flats or Parcels Entry Piece Rate Or Amount Affixed No of Pieces Pieces Subtotal Pound Rate Pounds Pounds Subtotal Total A2 None $0.122 A29 None 0.1 A0 None 0.19 A1 None 0.29 A2 None 0.11 A None 0.9 A None 0. A None A None 0.1 A None 0.19 A None 0.29 A9 None 0.11 A0 None 0.9 A1 None 0. A2 0.0 A 0.12 A 0.1 A 0.21 A 0.0 A 0.12 A 0.1 A A0 DSCF 0.0 A1 DSCF 0.0 A2 DDU 0.00 Part A Presorted BPM Total PS Form 0-R, May 200 (Page of 10) PSN

4 Part B Library Mail and Media Mail Library Mail B1 Basic / Rate No. of Pieces Total B2 B B B Single Piece -Digit Basic Single-Piece Media Mail B Basic / Rate No. of Pieces Total B B B9 B10 Single Piece -Digit Basic Single-Piece Part B Total PS Form 0-R, May 200 (Page of 10)

5 Part C Parcel Select Parcel Select Entry C1 / / Rate No. of Pieces Total C2 C C C C C C C9 DSCF C10 DSCF - -Digit C11 DSCF - -Digit C12 DDU Parcels C1 C1 C1 C1 C1 DSCF C1 DDU Part C Total PS Form 0-R, May 200 (Page of 10) PSN

6 Part D Single-Piece Parcel Post Single-Piece - D1 / BMC/ASF / Rate No. of Pieces Total D2 D D D D D D D9 D10 D11 D12 D1 D1 D1 D1 D1 D1 D19 D20 D21 D22 D2 D2 D2 D2 D2 D2 Part D - Single-Piece Total PS Form 0-R, May 200 (Page of 10)

7 Part D cont. Single-Piece Parcel Post Single-Piece - D29 Local / BMC/ASF / Rate No. of Pieces Total D0 D1 D2 D D Local D D D D D9 Local D0 D1 D2 D D Local D D D D Part D - Single-Piece Total PS Form 0-R, May 200 (Page of 10) PSN

8 Part E Parcel Post BMC Presort E1 / / Rate No. of Pieces Total E2 E E E E E E E9 E10 E11 E12 E1 E1 E1 E1 E1 E1 E19 E20 E21 E22 E2 E2 E2 E2 E2 E2 Part E - BMC Presort Total PS Form 0-R, May 200 (Page of 10)

9 Part E cont. Parcel Post OBMC Presort E29 / / Rate No. of Pieces Total E0 E1 E2 E E E E E E E9 E0 E1 E2 E E E E E E E9 E0 E1 E2 E E E E Part E - OBMC Presort Total PS Form 0-R9, May 200 (Page 9 of 10) PSN

10 Extra Services Part S Extra Service Items mailed with Extra Services must meet the mailing standards for the extra service. Fee No. of Pieces Total S1 Certificate of Mailing ( or more) $0. S2 S S S Collect on Delivery (COD) Delivery Confirmation (parcels only) Insurance S S Restricted Delivery.10 S Return Receipt (Electronic) 0. S9 Return Receipt (Form 11) 2.1 S10 Return Receipt for Merchandise.0 S11 S12 S1 Signature Confirmation (parcels only) Parcel Airlift (PAL) Special Handling Part S Total PS Form 0-R, May 200 (Page 10 of 10)

11 - 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 : 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 : 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 : 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 0-RI, May 200 (Instructions) PSN