USPS Statement 07.05.05 - Laserfiche WebLink

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4- United States Postal Service • ; i t ~,. i ~ i ~ ~ I Post Office: Note Mail Arrival Time Postage Statement -Standard Mail Letters and Flats Permit Imprint '~ ~ ~f .~~ a, i tors subiect to the nonmachinable surcharge and pieces sub)ect to the residual shape surcharge, use Form 3602-RS. ermit Molder's Name and Address. Telephcre Name and Address of Telephone Name and Address of Individual or ~ ~ and ~maii Address if Any Mailing Agent (If other Organ¢aUOn for Which Mailing Is Prepared (ll than permit holder) _, ; other than permd holder) E ~"i j~o~ has coo; ~ ~ J ~ Accessible Data Servicas~ w ~ U~ ~ pr~/~S ;~~ C `3 a ~ ~ PO Box 41357 Eugene OR flT404 , ~u~ BH ~ /~v y ~ ~ 4>i/~~~J L . c t:~ ~ ~, u y ~, ( °-' ~ C tt' ctC~C~~~ P ~~ ~ ~ ~/ U ID f t ~ CAPS Cus e . Dun & Bradstreet No Dun & Bradstreet No. Dun 8 Bradstreet No. Post Office of Mailing ~~ Processing Category (DMM C050) Mailing Date _ Federal Agency Cost Code Statement Seq. No. Number of Containers C Q~ et•,ers ^~ d~ ~ = j~j~isi ,n ~' Permit N Zf t~ ~ ^ Flats ^ Automation Flats (DMM C820) Weight of a Single Piece ~ _ pound ~--- Total Pieces ~ 303 `I/~ ~. ~~c~~ ,~ For Mail Enclosed Within Another Class If Sacked, Based on Total Weight C Bound Printed Library Metlia Parcel ^ Reribdicals ^ Matter ^ Mail ^ Mail ^ Post ^ 125 pcs. ^ 15 lbs. ^ both t~ C ' F`,or Mutomalion Rate Pieces, Enter Date of Address For Enhanced Carrier Route Rate Pieces, Enter Date For Enhanced Carrier Route Rate Pieces, Enter Date .~ IJlatdhing Coding DMM A950.3.0) and Coding (DMM A950.3.0) of Address Matching of Carrier Route Sequencing (DMM M050.4.0) ~ ~r- ;-_~l ~~~l ~ J-- ) _~ (~1 0-~ ~ S l U ~ _ For Automation Letters and Flats (3.3 oz. or less) Total From Part A (On reverse) 0 n. ~ For Presorted Letters and Flats (3.3 oz. or less) Total From Part B (On reverse) D ~ For Ehhanced Carrier Route Letters and Flats (3.3 oz. or less) Total From Part C (On reverse) ~ 5`~_ zj(j C o _ x All Letters and Flats More Than 3.3 oz. Total From Part D (On reverse) Poslmaster: Report total Total Postage (Add lines above) ~ post}ag in AIC 130. ~ FortJS S Use Only: Additional Postage Payment (State reason) . t3f tD :.-p " N ° Poslmaster. Report total 4 ,.~i ~'.. Total Adjus 05tage (Add additional posfage to total postage) a adltasted postage in Alc 130. .;; Th$ mailer's signature certifies acceptance of liability for and agreement to pay any revenue deficiencies assessed on this mailing, subject to appeal. If an ~ 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 ag@nt signs this form O ' ~ , agneeS to pay any deficiencies. In addition, agents may be liable for any deficiencies resulting from matters within their responsibility, knowledge, or control. v Thy mailer hereby certifies that all information furnished on this form is accurate, truthful, and complete; that the mail and the supporting documentation comply with ali postal standards and that the mailing qualifies for the rates and fees claimed; and that the mailing does not contain any matter prohibited by d law or postal regulation. C1 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. Sigtfattlre ailer or Age ~~ Name of o nt S Telephone yGl-aa~y l o Single Piece /" ' O d ~ Are ftgures at~left adjusted from mallet's entries? . IX yes ^ No ~' ~'~~:f+ .~ ~~,'~ ~~ !!!___"' ~ .r.,. Pound_ L[ ~ ~ z ; ,r 41 ~A H~"~1f}as1"~essot~i, L ~;~ '~~iX~ '~ '~y` ~ ~ y~'' "Y "" To 1 Plleeos , ~ ,Total Wal~ht ,,# ~* r +,~:~. _ x " C tins ~, To I y ~ ~~r ~„ ,~ ~R W - x ... .: . , ''' ~ N I''C iRdl~ '~ eon +'" ~ t ,~'/"~ ' s ~ (tY ~t~~ ,~ , P~~~t~' . ~ =:~ t n - e 4 '~ otPQS r . 2~ T t~ ~ca•., mettt, gird ~ .. !>is ~~a! ~ . ~' tf ' .f ~ ~-. G 1 .... ~ Aen~ o ,. _ _ .,.,.... ,.. .... This form and mailing standards available on Nostai txpforer a[ nrrpripe.usµs.yv.