Form 3500 – Fill Out and Use This PDF

Application for Periodicals Mailing Privileges (Continued)

Part D

			Type of Organization (Complete one row)							Attach to Application
	1. Benevolent or Fraternal			No. of Members			Publication is	 By society or order
							Published:	 Under auspices of society or order
Institutions/Societies										Certified copy of the constitution and bylaws and
				Type:
	2.	Society			 Literary  Professional  Historical				 Scientific	the resolution or order showing the date publica-
										tion was adopted by the organization
	3. Trade Union			Publication Is			 By trade union		 Under auspices
				Published:					of trade union
	4. Church or Church Organization			Publication Is			 Church	 Church organization		Evidence that the publication is actually issued
				Issued By:						by a church or church organization
			Is publication issued by	Is publication issued by a regularly				Is publication issued by a public or		Certified copy of the charter, articles of incorpora-
			a regularly incorporated	established state institution of				nonprofit private elementary school or
	5.	Institution of	institution of learning?	learning supported in whole or in				secondary institution of learning or its		tion, legislative act creating the institution and
										amendments thereto, and, when necessary, evi-
				part by public taxation?				administrative or governing body?
		Learning								dence to substantiate nonprofit status or support
			 Yes  No	 Yes		 No		 Yes	 No
										by public taxation
	6.	State Agency of Health, Public Charities, Corrections, Agriculture,						Agency Issuing Publication		Evidence that authorized agency issues the
		Conservation, Fish and Game, or Industrial Development								publication
	7. Educational Radio or Television Agency of a State or Political Subdivision							Category Under Which Applying		Evidence that authorized station issues the
		of a State, or a Nonprofit Educational Radio or Television Station								publication

Part F

PS Form 3500, December 2014 (Page 2 of 4)

INSTRUCTIONS FOR COMPLETING PS FORM 3500, APPLICATION FOR PERIODICALS MAILING PRIVILEGES

APPLICANT

Complete PS Form 3500 when applying for any category of Periodicals mailing privilege.

Information about Periodicals mail is published in the Domestic Mail Manual (DMM®). You can access the DMM on the Internet at http://pe.usps.gov.

If you're looking for...	Then turn to...
General eligibility for Periodicals rates	DMM 207.4
Standards for physical construction and mailpiece components	DMM 207.3
Postage rates for Periodicals	DMM 207.1

If you have questions about Periodicals mailing, check the DMM first. If you still need help:

—Call the manager of Business Mail Entry at the district office that serves your ZIP Code™. This information is listed in DMM 608.8.4.1

—Call the USPS® help line at 800-ASK-USPS®.

All publications must first meet these basic standards to qualify for Periodicals rates:

1.You must show intent to publish issues indefinitely with continuity from issue to issue. Your purpose must be to transmit information of a general or specific nature.

2.You must publish issues at a regular frequency of at least four times a year.

3.You must maintain a known office of publication where normal business is conducted during posted hours.

4.Your publication must be formed of printed sheets.

Completing the Application

There are several eligibility categories. Consult the DMM for full requirements, including advertising restrictions.

If...	Then your publication may be	And you can	To apply,
	eligible as a...	read more in...	complete...
At least 50 percent of your total distribution goes to	General Publication	DMM 207.6.1	Parts A and B
individuals who have paid above a nominal rate
At least 50 percent of your total distribution goes to	Requester Publication	DMM 207.6.4	Parts A and C
qualified requesters, whether or not they have paid for
the subscription
Your publication is issued by a state department of	Publication of a State Department	DMM 207.6.3	Parts A and D
agriculture	of Agriculture
Your publication originates in another country but you	Foreign Publication	DMM 207.6.6	Parts A and B
have a known office of publication through an agent
or broker in the United States
Your publication is issued by an institution or society	Publication of an Institution	DMM 207.6.2	Parts A and D
and contains the institution's or society's advertising	or Society With Publisher's
only	Advertising Only
Your publication is issued by an institution or society	Publication of an Institution or	DMM 207.6.2	Parts A, D, and E
and contains general advertising	Society With General Advertising

In addition, if your publication is issued by a nonprofit organization, you may qualify for discounted rates. Read DMM 207.10 and complete Part F.

If you are a person or business selling two or more publications from different publishers, you are considered a News Agent. Read DMM 207.6.7 and complete Part A. Attach a separate sheet listing the publications you handle and where they are published.

PS Form 3500, December 2014 (Page 3 of 4)

INSTRUCTIONS FOR COMPLETING PS FORM 3500 (Continued)

Filing the Application

Submit your application to the Post Office that serves your known office of publication. Bring all of the following:

1.A completed PS Form 3500.

2.For an application filed under the “General” or “Requester” category, the publisher must check the appropriate space in Part B or Part C, as applicable, if the application is being submitted under the New Launch procedure.

3.The publisher must check the applicable space in Part B or Part C, as applicable, if requesting or if required to have the initial audit of circulation be performed by an authorized audit bureau.

4.Two copies of the issue of the publication described in this application marked to show the advertising content. Indicate on the cover both the total units (e.g., column inches, square inches, pages) and the percentage of advertising and nonadvertising. If the publication is in a foreign language, provide a brief translation of its contents.

5.The application fee. This fee is nonrefundable and may be paid by cash, check (payable to “Postmaster”), or credit card.

6.If you intend to mail at a Post Office other than the Post Office that serves your known office of publication, you must submit a completed PS Form 3510-M, Application for Additional Mailing Office for Periodicals Publication.

Publisher's Records

You must make adequate records available to the Postal Service™ to permit verification of the figures on your application. The Postal Service will contact you to schedule this review. (Not applicable for an application filed under the “General” or “Requester” category if the initial verification of circulation will be performed by an authorized audit bureau.)

POSTMASTER

Process PS Form 3500 as follows:

1.Review the application for completeness.

2.Complete items 20 through 27 on page 1. Round-date the application in this area.

3.Forward the application and one marked copy of the publication to the manager of the Pricing and Classification Service Center (PCSC).

PRICING AND CLASSIFICATION SERVICE CENTER

90 CHURCH STREET, STE 3100

NEW YORK NY 10007-2951

PRICING AND CLASSIFICATION SERVICE CENTER

1.Review the application to determine if the basic Periodicals criteria are met.

2.If the criteria are met, the PCSC manager sends a memo to the postmaster or BME manager giving instructions on how to audit the publication, with a list of the specific records to be reviewed. These records may include the following, as applicable:

a.Print order and printer's invoice.

b.Mailing labels or a mailing list.

c.Subscription/requester list.

d.Records of newsstand and over-the-counter sales and returns.

e.Stubs or copies of receipts issued.

f.Records of vending machine sales and returns.

g.Records of membership dues paid (if they include a subscription fee).

h.Assignment and collection records for carriers other than USPS.

i.Cash receipts, cashbook, or similar source records that show subscription payments.

j.Records showing the number of copies destroyed.

k.Records of gift subscriptions.

l.Records of bulk orders.

3.Once the audit is completed and returned, the PCSC manager rules on the application.

PS Form 3500,	December 2014 (Page 4 of 4)	PRIVACY NOTICE: See our privacy policy on www.usps.com®.