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Postage Statement—Periodicals

United States Postal ServicePostage Statement PeriodicalsOne Issue or One Edition Unless Used as a Consolidated StatementPost Office: Note Mail Arrival Date & Time (Do Not Round-Stamp)MailerPublication Title and Owner or News Agent NameCAPS Cust. Ref. No. CRID Mailing Agent (Printer or Consolidator) Name, Address, Telephone, Email Printer/Consolidator Imprint Permit No. CRID Entry Post Office Name, State, and ZIP+4 MailingPublication s Mailing Date Statement Seq. No. For Automation Pieces, Enter Date of Address Matching and Coding / / For Carrier Route Pieces, Enter Date of Address Matching and Coding / / For Carrier Route Pieces, Enter Date of Carrier Route Sequencing / / For Pieces Bearing a Simplified Address Enter Date of Delivery Statistics File or Alternative Method / / No.

Periodicals—One Issue or One Edition Part A—In County PS Form 3541, January 2018 (Page 2 of 8) Check box if prices are populated in this section. Pound Price Entry Subscriber or

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