Usps Form 3623 – Fill Out and Use This PDF

Any organization currently authorized or that has filed an application that is pending authorization to mail at the Nonprofit Standard Mail prices by the Postal Service™ may obtain confirmation of authorization or pending application to mail at Nonprofit Standard Mail prices for mailings to be entered at a PostOffice™ outside the PostalOne!® system.

Confirmation of authorization to mail at Nonprofit Standard 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.

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.

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 Standard Mail prices.

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 Standard Mail prices is

needed.

4.Telephone Number (Include area code)

7. Estimated date of first mailing at Post Office indicated in item 6.

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 andcivil penalties).

Ifurtherunderstandthat,ifthisapplicationisapproved,apostagerefundforthe differencebetweentheregularStandardMailandNonprofitStandardMailprices maybemadeforonlythoseregularStandardMailmailingsenteredatthepost officeidentifiedabovewhilethisapplicationispending,providedthatthe conditionssetforthinDomesticMailManual703.1and703.1.9aremet.

8. Signature ofApplicant

9. Title

10. Date

Be sure that the applicant has completed items 1 to 10 in Part 1.

If the nationalauthorization number is known, the postmaster should

request confirmationby calling the Pricing and Classification Service

Center at one of the following numbers:

Retain applications approved by telephone at the Post Office.Acopy of the authorization letter sent to the applicant will be sent to the postmaster.

Send applications not processed by telephone to:

Pricing and Classification Service Center

PO Box 3623

NewYork NY 10008-3623

1.Check here if authorized by telephone and enter the authorization number issued by the PostalService.

2.Signature of Postmaster (Or designated representative)

3.DateApplication Filed With Post Office (Round stamp)