Usps Form 3624 – Fill Out and Use This PDF

Section B—General Information

Organization Eligibility

The Nonprofit Standard Mail prices may be granted only to:

1.The eight categories (01 through 08) of nonprofit organizations specified on page 1 in section A, item 9.

2.Qualified political committees (category 09), including the national and state committees of political parties as well as certain named congressional committees.

3.Voting registration officials (category 10), including local, state, and District of Columbia voting registration officials.

These organizations are defined in Domestic Mail Manual (DMM®) 703.1, available for review at pe.usps.com.

To qualify, a nonprofit organization must be both organized and operated for a primary purpose that is consistent with one of the types of organizations in DMM 703.1. Organizations that incidentally engage in qualifying activities do not qualify for the Nonprofit Standard Mail prices.

Application Procedures

1.Only organizations may apply. Individuals may not apply (except voting registration officials).

2.Only the one category in item 9 that best describes the primary purpose of the organization may be checked.

3.The application must be signed by someone in authority in the organization, such as the president or treasurer. It must not be signed by a printer or mailing agent.

4.The completed PS Form 3624 must be submitted to the Post Office where Nonprofit Standard Mail mailings will be deposited. If the application is approved, the authorization will apply nationwide. Use PS Form 3623 Request for Confirmation of Authorization (or Pending Application) to Mail at Nonprofit Standard Mail Prices to deposit at a Post Office location that does participate in PostalOne!.

Supporting Documentation

The documents listed in 1 and 2 below must be submitted with the completed applications for nonprofit organizations. The documents listed in 3 must be submitted for qualified political committees and, in 4, for voting registration officials.

1.Evidence that the organization is nonprofit and that none of its net income inures to the benefit of any private stockholder or individual. Acceptable evidence includes:

An Internal Revenue Service (IRS) letter of exemption from payment of federal income tax.

If an IRS exemption letter is not available, a complete financial statement from an independent auditor (such as a certified public accountant) substantiating that the organization is nonprofit. A statement from a member of the organization is not sufficient. (Do not submit State tax exemption information.)

2.Documents describing the organization’s primary purpose, such as:

Organizing instruments that state the purpose for which the group is organized, such as the constitution, articles of incorporation, articles of association, or trust indenture. The organizing instrument, including all amendments to the original, should bear the seal, certification, or signature of the Secretary of State or other appropriate state official. If one or more of these documents are not sealed, certified, or signed by state officials, an officer or other person authorized to sign for the applicant should submit a written declaration certifying that the documents are complete and accurate copies of the originals.

Materials showing how the organization actually operated during the previous 6 to 12 months and how it will operate in the future. Bulletins, financial statements, membership forms, publications produced by the organization, minutes of meetings, or a list of its activities may be used.

3.For qualified political committees (category 09), organizational or other documents substantiating that the applicant is the state or national committee of the political party.

4.For voting registration officials (category 10), a copy of the statute, ordinance, or other authority establishing responsibility for voter registration.

Mail Eligibility

An organization authorized to mail at the Nonprofit Standard Mail prices may mail only its own matter at those prices. It may not delegate or lend the use of its Nonprofit Standard Mail authorization to any other person or organization. Cooperative mailings may be made at the Nonprofit Standard Mail prices only if each of the cooperating organizations is individually authorized to mail at those prices.

DMM 703.1 discusses the specific restrictions against the mailing of certain advertising materials and products.

PS Form 3624, April 2012 (Page 2 of 3)

Postal Service™ Checklist for PS Form 3624,

Application to Mail at Nonprofit Standard Mail Prices

Name of Organization

The organization above provided the following evidence of eligibility for Nonprofit Standard Mail prices.

1.Nonprofit Status (Select at least one)

IRS letter of exemption from payment of federal income tax

Financial statement prepared by an independent auditor substantiating organization’s nonprofit status (statement must include balance sheets, notes, etc.)

Place of Worship

2.Organization (One complete copy; check all that apply. Must select at least one.)

3.Operation (Several samples of each; check types of information included with application)

Organizational or other documents substantiating that the applicant is the state or national committee of the political party

A copy of the statute, ordinance or other authority establishing responsibility for voter registration

Other (Explain):

The name on all the documents presented as evidence must match the name on the application. If they do not match, please explain.

Postmaster: PostalOne! offices must enter the information from the application into the PostalOne! system.

Non-PostalOne! offices must mail the application and documentation to the Pricing and Classification Service Center.

I certify that the applicant has completed all the items on the application and that each item is legible.