<br /> v~iited States Postal Service comments: USPS: Note Mail Arrival Date & Time <br /> <br /> Postage Statement -Standard Maii Set: (ValidUSPS21PCode(MainAddrGrp)) AND <br /> a <br /> Permit Holder's Name and Address and Telephone Name and dress' ~ T phone Name and Address of Individual or <br /> Email Address, If Any ( - Mailing Agent (If other (541 }461-0084 Organization for Which Mailing is Prepared <br /> Extension than permft holder) Extension (If other than permit holder) <br /> M City of Eugene Accessible Data Services (A.D.S.) City of Eugene <br /> q Mailing Services 795 River Ave Planning and Development <br /> j 44 W 7th Eugene OR 97404 99 W 10th Ave <br /> L Eugene OR 97401 Eugene OR 97401 <br /> E <br /> R data@ads-data.com q <br /> CAPS Cust Ref No. ~ a / <br /> Customer Number Customer Number Customer Number <br /> Post Office of Mailing Processing Category Mailin Da Fed. Agency Cost Code Statement Seq. No. <br /> Eugene OR 97601 [ ]Letters [ j CMM t'y ~j CESWO5 <br /> Type of [xl Permit Imprint [xJ Flats NFM Wei ht of a in le Piece Total Pieces No. of Containers <br /> Posts e f t Precanceled Stam s (1 Parcels • Machinable g g <br /> g p [ ]Parcels - Irtegular 0.0702 pounds 3,243 1' MM Trays <br /> M [ ]Metered 2' MM Trays <br /> [ j Letters - Paid as NFMs <br /> r <br /> A [ ]ECR letters -Paid as ECR Ftats 2' EMM T ayS <br /> I Permit # For Mail Enclosed Within Another Class If Sacked, Based on Total Wei ht Total Trays <br /> ~ g Flat Trays <br /> I 360 [ ] Periodigls (]Bound Printed Matter [ ] 125 pcs [ ] 151bs [ j Both 227.6586 Sacks 19 <br /> N [ ]Library Mail [ ]Media Mail [ ]Parcel Post Pallets <br /> G For Automation Price Pieces, Enter Date of For ECR Price Pieces, Enter Date of For ECR Price Pieces, Enter Date of Other <br /> Address Matching and Coding Address Matching and Codin Cartier Route Sequencing <br /> a ~ d~ ds' ~9 a Q <br /> Move Update method: [ ] Andllary service endorsement [ ] FASTforward [ ] NCOALink [ J ACS [ ] Altemale meth d [ j Multiple <br /> Parts Completed (Select all that apply) [ ] A [ ] B [ ] C [ ] D [X] E F [ ] G [ ] H [X] I [ ] J [ ] K [ ] L [ ] S <br /> Total Postage (Add Parts Totals) 519.84. <br /> p Price at Which Postage Affixed <br /> O [ ]Correct [ ]Lowest [)Neither pcs. x ~ = Postage Affixed <br /> t Net Postage Due (Subfract postage affrxed from total postage) <br /> G For USPS Use Only: Additional Postage Payment (State reason) <br /> E <br /> Forpostage axed add additional payment to net postage due; Total :Adjusted Postage Affixed <br /> for permit Imprint add additional payment to total postage. <br /> Postmaster. Report Total Postage in AIC 130 Total Ad'usted Posts a Permit Im rint <br /> (Permit Imprint Only) ~ _ : g p <br /> C 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 <br /> E 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 /> R agrees to pay any deficiencies. In addition, agents may be liable for any deficiencies resulting from matters within their responsibility, knowledge, or control. <br /> T The mailer hereby certifies that all information famished on this form is accurate, truthful, and complete; that the mail and the supporting documentation <br /> I comply with ail postal standards and that the mailing qualifies for the prices and fees claimed; and that the mailing does not contain any matter prohibited by <br /> F law or postal regulation. <br /> I I understand that anyone who furnishes false or misleading information on this form or who omits information requested on this fore may be subject to <br /> C criminal and/or civil penalties, including fines and imprisonment. Privacy Notice: For information regarding our Privacy Policy visit www.usps.com. <br /> A Signature of Mai r or Agent Printed Name of Mailer or Agent Signing Form Telephone <br /> T (~L <br /> I <br /> O 1/ ~ C Extension <br /> N _J`?/T ~J <br /> Weight of a Single Piece Are postage figures at left adjusted from mailer's entries? [ ]Yes [ ) No <br /> If "Yes" state reason: <br /> _ pound <br /> U Total Pieces Total Weight - <br /> S <br /> P - <br /> S Total Postage Round Stamp (Required): <br /> U <br /> S Presort Verification Perfomted7 (Check One) Date Mailer Notified Contact By (Initials) P,\\- EN rR)~ <br /> E [)Yes No ~Jr~~~G~~~iji,~ <br /> ~ I CERTIFY that this mailin has been ins ected concemin : 1 ell ibili for osta a noes claimed; <br /> N 9 P 9 9 tY P. 9 P~ <br /> ~ (2) proper preparation (and presort where required); (3) proper completion of postage statement; and ~ <br /> Y (4) payment of annual fee (if required). <br /> Verifying Employee's Signature Print Verifying Employee's Name Time AM <br /> PM <br /> PS Form 3602-R, May 2008 (Page 1 of 3) Facsimile (Mail Manager 2010 02.11.1) <br /> <br />