Ps Form 3526 R – Fill Out and Use This PDF

Statement of Ownership, Management, and Circulation (Requester Publications Only)

7. Complete Mailing Address of Known Office of Publication (Not printer) (Street, city, county, state, and ZIP+4®)		Contact Person
		Telephone (Include area code)
8.	Complete Mailing Address of Headquarters or General Business Office of Publisher (Not printer)
9.	Full Names and Complete Mailing Addresses of Publisher, Editor, and Managing Editor (Do not leave blank)
Publisher (Name and complete mailing address)

Editor (Name and complete mailing address)

Managing Editor (Name and complete mailing address)

10.Owner (Do not leave blank. If the publication is owned by a corporation, give the name and address of the corporation immediately followed by the names and addresses of all stockholders owning or holding 1 percent or more of the total amount of stock. If not owned by a corporation, give the names and addresses of the individual owners. If owned by a partnership or other unincorporated firm, give its name and address as well as those of each individual owner. If the publication is published by a nonprofit organization, give its name and address.)

11.Known Bondholders, Mortgagees, and Other Security Holders Owning or Holding 1 Percent or More of Total Amount of Bonds, Mortgages, or

Other Securities. If none, check box. None

12.Tax Status (For completion by nonprofit organizations authorized to mail at nonprofit rates) (Check one)

The purpose, function, and nonprofit status of this organization and the exempt status for federal income tax purposes:

Has Not Changed During Preceding 12 Months

Has Changed During Preceding 12 Months (Publisher must submit explanation of change with this statement.)

PS Form 3526-R, July 2014 [Page 1 of 4 (See instructions page 4)] PSN: 7530-09-000-8855 PRIVACY NOTICE: See our privacy policy on www.usps.com.

13.	Publication Title	14. Issue Date for Circulation Data Below
15.	Extent and Nature of Circulation	Average No. Copies	No. Copies of Single
		Each Issue During	Issue Published
		Preceding 12 Months	Nearest to Filing Date

a. Total Number of Copies (Net press run)

			Outside County Paid/Requested Mail Subscriptions stated on PS Form 3541.
			(Include direct written request from recipient, telemarketing, and Internet
		(1) requests from recipient, paid subscriptions including nominal rate subscriptions,
			employer requests, advertiser’s proof copies, and exchange copies.)
	b. Legitimate
	Paid and/or		In-County Paid/Requested Mail Subscriptions stated on PS Form 3541.
	Requested
			(Include direct written request from recipient, telemarketing, and Internet
	Distribution (2)
			requests from recipient, paid subscriptions including nominal rate subscriptions,
	(By mail		employer requests, advertiser’s proof copies, and exchange copies.)
	and
	outside
	the mail)	(3)	Sales Through Dealers and Carriers, Street Vendors, Counter
			Sales, and Other Paid or Requested Distribution Outside USPS®
		(4)	Requested Copies Distributed by Other Mail Classes Through the USPS
			(e.g., First-Class Mail®)

c. Total Paid and/or Requested Circulation (Sum of 15b (1), (2), (3), and (4))

			Outside County Nonrequested Copies Stated on PS Form 3541 (include
(1)			sample copies, requests over 3 years old, requests induced by a premium,
			bulk sales and requests including association requests, names obtained
			from business directories, lists, and other sources)
d. Non-			In-County Nonrequested Copies Stated on PS Form 3541 (include sample
requested (2)			copies, requests over 3 years old, requests induced by a premium, bulk
Distribution			sales and requests including association requests, names obtained from
(By mail			business directories, lists, and other sources)
and
outside
the mail)			Nonrequested Copies Distributed Through the USPS by Other Classes of

(3)Mail (e.g., First-Class Mail, nonrequestor copies mailed in excess of 10% limit mailed at Standard Mail® or Package Services rates)

Nonrequested Copies Distributed Outside the Mail (Include pickup stands,

(4)trade shows, showrooms, and other sources)

e. Total Nonrequested Distribution [Sum of 15d (1), (2), (3) and (4)]

f. Total Distribution (Sum of 15c and e)

g. Copies not Distributed (See Instructions to Publishers #4, (page #3))

h.Total (Sum of 15f and g)

i.Percent Paid and/or Requested Circulation (15c divided by 15f times 100)

* If you are claiming electronic copies, go to line 16 on page 3. If you are not claiming electronic copies, skip to line 17 on page 3.

PS Form 3526-R, July 2014 (Page 2 of 4)

Statement of Ownership, Management, and Circulation

(Requester Publications Only)

16. Electronic Copy Circulation	Average No. Copies	No. Copies of Single
	Each Issue During	Issue Published
	Previous 12 Months	Nearest to Filing Date
a. Requested and Paid Electronic Copies

b.Total Requested and Paid Print Copies (Line 15c) + Requested/Paid Electronic Copies (Line 16a)

c.Total Requested Copy Distribution (Line 15f) + Requested/Paid Electronic Copies (Line 16a)

d.Percent Paid and/or Requested Circulation (Both Print & Electronic Copies) (16b divided by 16c Í 100)

I certify that 50% of all my distributed copies (electronic and print) are legitimate requests or paid copies.

17.Publication of Statement of Ownership for a Requester Publication is required and will be printed in the issue of this publication.

18. Signature and Title of Editor, Publisher, Business Manager, or Owner

Date

I certify that all information furnished on this form is true and complete. I understand that anyone who furnishes false or misleading information on this form or who omits material or information requested on the form may be subject to criminal sanctions (including fines and imprisonment) and/or civil sanctions (including civil penalties).

PS Form 3526-R, July 2014 (Page 3 of 4)

PRIVACY NOTICE: See our privacy policy on www.usps.com.

Instructions to Publishers

1.Complete and file one copy of this form with your postmaster annually on or before October 1. Keep a copy of the completed form for your records.

2.In cases where the stockholder or security holder is a trustee in items 10 or 11, include the name of the person or corporation for whom the trustee is acting. Also include in item 10 the names and addresses of all stockholders owning or holding one (1) percent or more of the total amount of stock. If not owned by a corporation, give the name and address of each individual owner. If owned by a partnership or other unincorporated firm, give its name and address as well as the name and address of each individual owner. If the publication is published by a nonprofit organization, give its name and address and complete item 12. In item 11, include all bondholders, mortgagees, and other security holders owning or holding one (1) percent or more of the total amount of bonds, mortgages, or other securities. If none, check the box. Use blank sheets if more space is required.

3.Be sure to furnish all circulation information called for in item 15. Free Non-Requested circulation must be shown in item 15d.

4.Item 15g, Copies not Distributed, must include (1) newsstand copies returned to the publisher, (2) estimated returns from news agents, and (3), copies for office use, leftovers, spoiled, and all other copies not distributed.

5.As a requester publication, this Statement of Ownership, Management, and Circulation must be published, i.e., it must be printed in an issue that’s primary mailed distribution is produced not later than October 10 for publications issued more frequently than weekly; or not later than October 31 for publications issued weekly or less frequently but more frequently than monthly; or in the first issue that’s primary mailed distribution is produced after October 1 for all other publications.

6.In item 16, check the box if electronic copies are being included in your total distribution and complete line items 16a through d.

7.In item 17, report the date of the issue in which this Statement of Ownership will be published, if applicable.

8.Item 17 must be signed.

Failure to file or publish a statement of ownership may lead to suspension of periodicals authorization.

PS Form 3526-R, July 2014 (Page 4 of 4)