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Uni~d St~t~es Postal Service ' ~ ; f 1~ ~'~!;~ ~,~ ~~
<br />Postage Statement -- Standard Mail Letters and Flats ,,'~a,,~,,~ yj--°~' a f
<br />Permit Imprint ~`- -
<br />Post Office: Note Mail Arrival Time
<br />F~,,, grs Subject to the nonmachmable surcharge and pieces subject to the residual shape surcharge, use Form 3602-RS.
<br /> ermit',Holder's Name and Address, Telephcre Name and Address of Telephone ~ Name and Address of Individual or
<br />~ and Email Address If Any fvlading Agent (bother I Orgarnzahon for Which Mailing Is Prepared !!r
<br />~ I than permd holder) other than permd holder)
<br />E ~l~q ~rs~~~ Accessible Data Servtcsa
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<br />Eugene OR 1x7404 ~u
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<br />Dun 8 Bradstreet No Dun & Bradstreet No. Dun & Bradstreet No.
<br /> Post Office of Marling Processing Category ju^MM C050) Mailing Date Federal Agency Cost Code Statement Seq. No. Number of Containers
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<br />7~O ^ Flats
<br />^ Automation Flats (DMM C820) Weight of a Single Piece
<br />~ , _ _ _ _ pound Total Pieces
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<br />,~ Fos Mpil Enclosed Within Another Class If Sacked, Based on Total Weight
<br />~ Bound Printed Library ,- Media Parcel
<br />^ Periodicals ^ Matter ^ Mail L--I Mail ^ Post
<br />^ 125 pos. ^ 15 lbs. ^ both
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<br />For Automation Rate Pieces, Enter Date of Address For Enhanced Carrier Route Rate Pieces, Enter Date
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<br />For Enhanced Carrier Route Rate Pieces, Enter Date
<br />~ Matching Coding jDMM A950 3.0) of Address Matching and Coding (DMM A950.3.0) of Carrier Route Sequencing (DMM M050.4.0)
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<br />~ For Automation Letters and Flats (3.3 oz. or less) Total From Part A (On reverse)
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<br />~ Fpr Presorted Letters and Flats (3.3 oz. or less) Total From Part B (On reverse)
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<br />~ Fbr ~nhanced Carrier Route Letters and Flats (3.3 oz. or less) Total From Part C (On reverse) ~ S~G_ zj(j
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<br /> ~r iAll Letters and Flats More Than 3.3 oz. Total From Part b (On reverse)
<br /> Postmaster Report total Total Posts a Add lines above
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<br />p postage in AIC 130.
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<br />01 Far LISPS Use Only: Addlt(onal Postage Payment (State reason]
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<br /> 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
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<br />p 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
<br /> agrees to pay any deficiencies. in addition, agents may be liable for any deficiencies resulting from matters within their responsibility, knowledge, or control.
<br />u The mailer hereby certifies that al! information furnished on this form is accurate, truthful, and complete; that the mail and the supporting documentation
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<br />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
<br />m taw or postal regulation.
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<br />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
<br /> criminal and/or civil penalties, including fines and imprisonment.
<br /> $igrjature slier or Age
<br />O'f-~ Name of o nt
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<br />~ qre figures at left adjusted from mailer's entries? Yes
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<br />PS Form 3602-R, June 2002 (Page 1 of 2)
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