The PS 3541 form, a detailed document created by the United States Postal Service (USPS), serves as a postage statement for periodicals either for a single issue or one edition, and can also be used for consolidated statements under certain conditions. This form is essential for publishers and mailing agents (such as printers or consolidators) to accurately report and pay postage costs associated with the mailing of periodicals. It includes sections covering the mailing office, mailer details, the publication title, processing categories, and postage fees for both in-county and outside-county mailings. Additionally, it specifies different price categories, including regular, nonprofit, and science of agriculture rates, offering discounts under specific circumstances. The form intricately details the weight of the mail pieces, the advertising percentage, the number and type of containers used, and requires certifications from the mailer regarding the accuracy of the information provided and compliance with postal regulations. Importantly, it also outlines the responsibilities and potential liabilities of both the mailer and their agent, thereby ensuring that all parties are aware of their obligations under postal law. A privacy notice concludes the form, reassuring users about the handling of their information. Given its complexity and the detailed information it demands, preparing and submitting the PS 3541 form accurately is crucial for periodical mailings to meet USPS requirements and to secure the associated postage discounts.
| Question | Answer |
|---|---|
| Form Name | Ps Form 3541 |
| Form Length | 8 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 2 min |
| Other names | DDU, june, Barcoded, 3541-1 |
United States Postal Service
Postage Statement - Periodicals
One Issue or One Edition Unless Used as a Consolidated Statement
Post Office: Note Mail Arrival Date & Time (Do Not
Mailer
Mailing
Publication Title and Owner or News Agent's Name Mailing Agent's (Printer or Consolidator) Name, Address, Telephone Number, |
Entry Post Office Name, State, and ZIP+4 |
and Email Address if Any |
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CAPS Customer Ref. No. |
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Printer/Consolidator Imprint Permit No. |
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CRID |
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CRID |
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Applicable Parts Completed |
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Statement for bundles/ |
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Price Category |
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Regular |
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Nonprofit |
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Combined Mailing |
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Consolidated Postage Statement |
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(select all that apply) |
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containers only |
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Mixed Class |
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A |
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B - E |
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F |
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(If Applicable) |
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Classroom |
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Single Class |
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Yes |
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No |
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Publication No. |
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Edition/Code |
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Mailer's Mailing Date |
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Processing Category |
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No. of Addressed Pieces |
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Number of Addressed Supplements |
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Letters |
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Excluding Addressed |
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Flats |
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Supplements |
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Issue Date |
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Issue Frequency |
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Statement Sequence No. |
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Parcels |
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Weight of |
a Single |
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Weight per Copy for Issue (Round off to 4 decimal |
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Advertising Percentage in This |
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Number and Type of Containers. (Enter total number of |
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places if necessary) |
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Issue |
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containers) |
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0 . ___ ___ ___ ___ lb. |
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____ ____ . ____ ____ ____ ____ pounds |
____ ____ . ____ ____ % |
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_____ Trays _____ Sacks _____ Pallets |
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For Automation Pieces, Enter Date |
For Carrier Route Pieces, Enter Date |
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For Carrier Route Pieces, Enter |
For pieces bearing a simplified address enter date of |
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of Address Matching and Coding |
of Address Matching and Coding |
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Date of Carrier Route Sequencing |
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delivery statistics file or alternative method |
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____ ____ / ____ ____ / ___ ___ ___ ___
____ ____ / ____ ____ / ___ ___ ___ ___
____ ____ / ___ ___ / ___ ___ ___ ___
____ ____ / ___ ___ / ___ ___ ___ ___
Postage
Certification
Part A -
Part B - |
Total Part B (Page 3) |
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Part C - |
Total Part C (Page 4) |
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Part D - |
Total Part D (Page 5) |
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Part E - |
Total Part E (Page 6 &7) |
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Subtotal Parts B, C, D, and E |
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Preferred Price Discount - Nonprofit, Classroom, Limited Circulation, Limited Circulation Science of |
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Agriculture (Add line B16, and parts C, D, and E Totals) _____ X .05 (all others enter zero) |
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Subtract the Preferred Price Discount from the |
= |
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Part F - |
+ |
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Total
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Add Total |
Total Postage |
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(AIC 224 + AIC 135) |
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The signature of the owner of the publication certifies acceptance of liability for and agreement to pay any revenue deficiencies assessed on this mailing, subject to appeal. If an agent signs this form, the agent certifies that he or she is authorized to sign on behalf of the owner of the publication and that the owner of the publication is bound by the certification and agrees to pay any deficiencies. In addition, agents may be liable for any deficiencies resulting from matters within their responsibility, knowledge, or control. The owner of the publication hereby certifies that all information furnished on this form is accurate, truthful, and complete; that the mail and the supporting documentation comply with all postal standards and the mailing qualifies for the prices and fees claimed; and that the mailing does not contain any matter prohibited by law or postal regulation. 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.
Privacy Notice: For information regarding our Privacy Policy visit www.usps.com.
Owner or Agent's Name
Owner or Agent's Signature
Name and Telephone Number of Contact Person in Publisher's Office
USPS Use Only To be completed in
Post Office Computed Weight per Copy
(Round off to 4 decimal places if necessary)
____ ____ . ____ ____ ____ ____ pounds
Time |
AM |
PM |
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USPS Employee's Signature |
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Print USPS Employee's Name |
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Round Stamp (Required)
Payment Date
USPS Use Only To be completed in
PS Form
Periodicals - One Issue or One Edition -
Part A
Check box at left if prices are populated in this section.
Pound Price |
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Subscriber or |
Nonsubscriber or |
Total |
Total |
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Total |
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Entry |
Requester |
Nonrequester |
Price |
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Copies |
Pounds |
Postage |
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Copies |
Copies |
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A1 |
DDU |
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$0.145 |
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A2 |
None |
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0.189 |
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A3 |
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Total Pound Price Postage (Add lines A1 and A2) |
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Piece Price (Presort) |
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Entry / Zone |
Presort Discount |
Total |
Addressed |
Price |
Total |
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Copies |
Pieces |
Postage |
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A4 |
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Nonautomation |
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$0.133 |
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A5 |
Basic |
Automation Letters |
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0.060 |
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A6 |
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Automation Flats |
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0.117 |
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A7 |
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Nonautomation |
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0.121 |
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A8 |
Automation Letters |
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0.050 |
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A9 |
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Automation Flats |
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0.109 |
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A10 |
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Nonautomation |
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0.108 |
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A11 |
Automation Letters |
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0.048 |
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A12 |
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Automation Flats |
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0.102 |
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A13 |
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Basic |
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0.061 |
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A14 |
Carrier Route |
High Density |
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0.045 |
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A15 |
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Saturation |
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0.031 |
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A16 |
Presort Subtotal (Add lines |
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A17 Number of Addressed Pieces at DDU Prices |
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0.008 |
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A18
Piece Price Subtotal (A16 minus A17)
Full Service Intelligent Mail Option
A19
A20
Number of pieces that comply ____________ x $0.001 =
Periodicals
(Must equal the number of copies in line A16, not number of addressed pieces)
A21
Repositionable Notes
(Must equal the number of copies in line A16, not number of addressed pieces)
A22 Repositionable Notes
Total |
Addressed |
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Total |
Copies |
Pieces |
Price |
Postage |
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0.165 |
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Total |
Addressed |
Price |
Total |
Copies |
Pieces |
Postage |
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0.005 |
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A23
Other Subtotal(Add lines A21 and A22)
Part A Total (Add lines A3, A20, and A23) Postmaster: Report in AIC 224
PS Form 3541, June 2012 (Page 2 of 7)
Periodicals - One Issue or One Edition -
Part B
Check box at left if prices are populated in this section.
For Nonprofit & Classroom: All commingled nonsubscriber or nonrequester copies over the 10% limit must pay regular prices & use a separate PS Form 3541.
Advertising Pound Prices |
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Price |
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Subscriber or |
Nonsubsc. or |
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Advertising |
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Total |
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Entry Zone |
Requester |
Nonreq. |
Total Copies Total Pounds |
Reg |
Sci/Ag |
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Copies |
Copies |
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Pounds |
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Postage |
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B1 |
DDU |
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$0.135 |
$0.101 |
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B2 |
DSCF |
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0.206 |
0.155 |
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B3 |
DADC |
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0.219 |
0.164 |
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B4 |
1 & 2 |
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0.244 |
0.183 |
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B5 |
3 |
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0.267 |
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B6 |
4 |
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0.327 |
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B7 |
5 |
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0.417 |
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B8 |
6 |
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0.512 |
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B9 |
7 |
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0.626 |
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B10 |
8 |
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0.723 |
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B11 |
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Subtotal (Add lines |
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Nonadvertising Pound Prices |
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Price |
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Total |
minus |
Advertising |
equals |
Nonadvertising |
X |
Reg |
Sci/Ag |
Total Postage |
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Pounds |
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Pounds |
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Pounds |
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B12 |
DDU |
(From B1) |
(From B1) |
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$0.113 |
$0.113 |
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B13 |
DSCF |
(From B2) |
(From B2) |
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0.171 |
0.171 |
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B14 |
DADC |
(From B3) |
(From B3) |
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0.182 |
0.182 |
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B15 |
All Others |
(From |
(From |
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0.203 |
0.203 |
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B16 |
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Subtotal (Add lines |
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Pound Price Postage Total (Add lines B11 and B16)
Nonadvertising Pound Prices - Alternate (Nonprofit and Classroom publications with 10% or less advertising, or other publications with 0% advertising.)
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Price |
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Subscriber or |
Nonsubsc. or |
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Entry Zone |
Requester |
Total Copies Total Pounds |
Reg |
Sci/Ag |
Total Postage |
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Nonreq. Copies |
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Copies |
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B12 |
DDU |
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$0.113 |
$0.113 |
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B13 |
DSCF |
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0.171 |
0.171 |
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B14 |
DADC |
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0.182 |
0.182 |
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B15 |
All Others |
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0.203 |
0.203 |
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B16 |
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Subtotal (Add lines |
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Part B Total - Pound Price Total (Add lines B11 and B16)
PS Form
Periodicals - One Issue or One Edition -
Part C
Check box at left if prices are populated in this section.
Machinable Flats |
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Level |
Price Level |
Total Copies |
Addressed Pieces |
Price |
Total |
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Postage |
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C1 |
Mixed ADC |
Barcoded |
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$0.414 |
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C2 |
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Nonbarcoded |
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0.446 |
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C3 |
ADC |
Barcoded |
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0.387 |
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C4 |
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Nonbarcoded |
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0.411 |
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C5 |
Barcoded |
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0.372 |
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C6 |
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Nonbarcoded |
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0.394 |
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C7 |
Barcoded |
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0.285 |
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C8 |
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Nonbarcoded |
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0.294 |
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Nonmachinable Flats |
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C9 |
Mixed ADC |
Barcoded |
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$0.580 |
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C10 |
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Nonbarcoded |
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0.625 |
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C11 |
ADC |
Barcoded |
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0.482 |
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C12 |
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Nonbarcoded |
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0.507 |
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C13 |
Barcoded |
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0.420 |
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C14 |
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Nonbarcoded |
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0.431 |
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C15 |
Barcoded |
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0.310 |
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C16 |
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Nonbarcoded |
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0.311 |
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Parcels |
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C17 |
Mixed ADC |
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$0.625 |
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C18 |
ADC |
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0.507 |
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C19 |
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0.431 |
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C20 |
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0.311 |
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Letters |
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C21 |
Mixed ADC |
Barcoded |
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$0.323 |
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C22 |
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Nonbarcoded |
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0.446 |
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C23 |
ADC |
Barcoded |
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0.283 |
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C24 |
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Nonbarcoded |
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0.411 |
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C25 |
Barcoded |
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0.262 |
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C26 |
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Nonbarcoded |
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0.394 |
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C27 |
Barcoded |
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0.200 |
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C28 |
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Nonbarcoded |
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0.294 |
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Carrier Route & Firm Bundles |
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C29 |
Basic |
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$0.187 |
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C30 |
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0.156 |
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C31 |
Saturation |
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0.136 |
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C32 |
Firm Bundle (Use "Addressed Pieces" to |
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0.184 |
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calculate postage) |
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C33 |
Subtotal (Add lines C1 through C32) |
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C34 |
Nonadv. % (100 minus adv.%) _____ X # of Addressed Pieces (C33) X $0.00101 |
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C35 |
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Subtotal Outside County Piece Prices (Line C33 minus C34) |
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Full Service Intelligent Mail Option
C36
Number of pieces that comply ______ x $0.001 =
Part C Total (Line C35 minus C36)
PS Form 3541, June 2012 (Page 4 of 7)
Periodicals - One Issue or One Edition -
Part D
Check box at left if prices are populated in this section.
Outside County - Bundle Prices
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Container Level |
Bundle Level |
Bundles |
Price |
Total |
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Postage |
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D1 |
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Mixed ADC |
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$0.079 |
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D2 |
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ADC |
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0.208 |
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D3 |
Mixed ADC |
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0.276 |
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D4 |
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0.285 |
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D5 |
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Firm |
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0.185 |
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D6 |
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ADC |
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0.115 |
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D7 |
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0.190 |
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D8 |
ADC |
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0.206 |
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D9 |
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Carrier Route |
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0.325 |
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D10 |
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Firm |
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0.154 |
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D11 |
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0.129 |
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D12 |
SCF/ |
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0.150 |
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D13 |
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Carrier Route |
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0.288 |
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D14 |
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Firm |
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0.142 |
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D15 |
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0.145 |
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D16 |
CR/ |
Carrier Route |
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0.152 |
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D17 |
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Firm |
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0.079 |
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Part D Total (Add lines
PS Form