PS Form 3623 at a glance
What it is: PS Form 3623 is the Request for Confirmation of Authorization (or Pending Application) to Mail at Nonprofit USPS Marketing Mail Prices.
Who signs: The organization name in item 1 must match the name of the authorized organization exactly. The applicant named in item 3 must be an authorized official of the organization completing this form.
A filled-in PS Form 3623 example: a pending application for one Post Office
How to fill out PS Form 3623, box by box
Complete Name of Organization, Street Address and Telephone Number
Enter the Complete Name of Organization in Box 1.
Enter the Street Address of Organization in Box 2: Number, street, apartment or suite number, city, state, and ZIP+4.
Enter the Name of Person Making this Request in Box 3, who must be a responsible official of the requesting organization.
Enter the Telephone Number in Box 4, including area code.
Authorization number, Post Office and Estimated date of first mailing
Enter the Nonprofit USPS Marketing Mail authorization number or pending application number in Box 5.
In Box 6, enter the Post Office (not station or branch) where mailings will be made and where confirmation of authorization or application pending authorization to mail at Nonprofit USPS Marketing Mail prices is requested.
File a separate request for confirmation for each Post Office (not a station or a branch) outside the PostalOne! system for which your organization wants to mail at Nonprofit USPS Marketing Mail prices.
Enter the Estimated date of first mailing at the Post Office indicated in item 6, in Box 7.
Signature of Applicant, Title and Date
"I certify that the statements made by me are true and complete. I understand that anyone who furnishes false or misleading information on this form or who omits material information requested on the form may be subject to criminal sanctions (including fines and imprisonment) and/ or civil sanctions (including multiple damages and civil penalties)."
Sign in Signature of Applicant, then enter Title and Date.
More rules for PS Form 3623
Any organization currently authorized or that has filed an application that is pending authorization to mail at the Nonprofit USPS Marketing Mail prices by the Postal Service may obtain confirmation of authorization or pending application to mail at Nonprofit USPS Marketing Mail prices for mailings to be entered at a Post Office outside the PostalOne! system.
Confirmation of authorization to mail at Nonprofit USPS Marketing Mail prices or application pending to mail at those prices will be issued only to the organization holding the original authorization or that has applied for authorization.
Common questions about PS Form 3623
Where do I file it?
Submit the completed request to the postmaster at the Post Office outside the PostalOne! system where confirmation of authorization or pending application to mail at Nonprofit USPS Marketing Mail prices is needed.
Are there fees?
No application fee is required. Please be sure all information is complete. Please type or print legibly.
Sources
[1] PS Form 3623, January 2017, Request for Confirmation of Authorization (or Pending Application) to Mail at Nonprofit USPS Marketing Mail Prices, United States Postal Service (the Official source link on this page).