ASM - Directives and Forms Index - npmhul310.org

1 Directives and Forms IndexContents623 ASM 13, July 1999 Updated With Postal Bulletin Revisions Through October 7, 1999 Directives and Forms IndexForms Note: All Forms listed with the citation Exhibit are those listed in Exhibit , RetentionPeriods for Post Office Forms , which begins on page s City or County Withholding CertificateExhibit RecordExhibit Items Requisition from Stamp DistributionOfficeExhibit SheetExhibit Fund AccountExhibit and Admittance Identification Credential s Identification Card (Green Card) Travel Order Relocation & RelocationAgreementExhibit Plan for New Directives and Registered Article or Insured Parcel orOrdinary ParcelExhibit of $100 or More in FinancialResponsibilityExhibit 225, Exhibit Card Non-Receipt ReportExhibit 225673 Report of Rifled ParcelExhibit 225697 Extension of City Delivery ServiceExhibit Transmittal and ReceiptExhibit , Report of Originating Registered and CODT ransactionsExhibit Planning Facility Planning Office Property RecordExhibit Recycling and DisposalExhibit for Promotion or ReassignmentExhibit Claim or Registered Mail InquiryExhibit Advance Request and Itinerary ScheduleExhibit VoucherExhibit Disallowance RecordExhibit Overtime RecordExhibit Office Box Fee RegisterExhibit for Caller Service FeesExhibit and Forms IndexContents624 ASM 13, July 1999 Updated With Postal Bulletin Revisions Through October 7, 1999 Forms (cont d)Note.

2 All Forms listed with the citation Exhibit are those listed in Exhibit , RetentionPeriods for Post Office Forms , which begins on page for Post Office Box or Caller ServiceExhibit , , for Post Office Box Key or Lock ServiceExhibit ReceiptExhibit , of Organization Dues from PayrollWithholdingsExhibit Savings Bond Authorization for Purchase andRequest for ChangeExhibit DepositExhibit s Current Mailing AddressExhibit Sick Leave AuthorizationExhibit Duty Leave Statement of ServiceExhibit Card Week 1 Exhibit Card Week 2 Exhibit Card Other ServiceExhibit CardExhibit Loan, Transfer, and Training HoursExhibit Ordered Child Care or Alimony PaymentExhibit Garnishment Withholding Notice or WageEarner Plan Allotment RequestExhibit CardExhibit ReportExhibit Loaned Employee Nontransactor CardExhibit Suggestion Control RecordExhibit SuggestionExhibit Transportation AgreementExhibit Transportation PaymentsExhibit Rural Carrier Time CertificateExhibit Rural Carrier Time CertificateExhibit for Computer Identification s Identification for Payment of Postmaster Replacementand/or RSC Postmaster ChangesExhibit Financial FormExhibit , , , and Forms IndexContents625 ASM 13, July 1999 Updated With Postal Bulletin Revisions Through October 7, 1999 Forms (cont d)Note.

3 All Forms listed with the citation Exhibit are those listed in Exhibit , RetentionPeriods for Post Office Forms , which begins on page Financial ReportExhibit , , , EMR Items TranscriptExhibit of Checks Drawn on Symbol 9500 Exhibit Copy 9500 FormExhibit by Shipper of FirearmsExhibit s Application for Recall of MailExhibit Loss/Rifling ReportExhibit 225, Exhibit Check of Overflow MailExhibit for Post Office Box/Caller Service FeesExhibit Point Delivery RequirementsExhibit for Post Offices and Financial ReportingUnits CAGs A - LExhibit for CAGs K - L (Looseleaf)Exhibit of Account (CAGs K - L)Exhibit of Account (CAGs H - J)Exhibit of AccountExhibit Items Support InformationExhibit Change SheetExhibit InstructionsExhibit OrdersExhibit for Rubber and Steel Hand CancelingStampsExhibit Mail ReportExhibit for Duplicating for Facing Slips or LabelsExhibit for Delivery of Mail Through AgentExhibit , RecordExhibit Assignment and Mail Count (MessengerOperations)Exhibit of Trust Fund BalanceExhibit Salary Authorization and ReceiptExhibit Management ReportExhibit Purpose Ruled FormExhibit Key , and Forms IndexContents626 ASM 13, July 1999 Updated With Postal Bulletin Revisions Through October 7, 1999 Forms (cont d)Note.

4 All Forms listed with the citation Exhibit are those listed in Exhibit , RetentionPeriods for Post Office Forms , which begins on page Investigation , Exhibit for Preferred AssignmentExhibit OrderExhibit LogExhibit Suggestion EvaluationExhibit Acknowledgment/AdviceExhibit Recommendation/AuthorizationExhibit Analysis SummaryExhibit of Hazard, Unsafe Condition or PracticeExhibit Driver Award Committee DecisionExhibit Report (3-part snap-out w/13-part instructionbook)Exhibit Materials Incident ReportExhibit LogExhibit of Hazard LogExhibit Safety Review/AnalysisExhibit and Health Inspection Checklist (Facilities over10,000 sq ft)Exhibit and Health Inspection Checklist (for Facilitiesless than 10,000 sq ft)Exhibit and Health Deficiency ReportExhibit s Certification of SDM EquipmentMaintenanceExhibit Leaving and Returning Report First CarrierDelivery TripExhibit Employment Opportunity s Count of Mail Letter Carrier Routes ( )Exhibit s Count of Parcel Post & Combination ServicesWorksheet/Management SummaryExhibit Post Firm Delivery WorksheetExhibit s Count of Mail Letter Carrier RoutesWorksheetExhibit Record for Carrier Drive-Out AgreementsExhibit Delivery Route Summary of Count andInspectionExhibit Timecard AnalysisExhibit and Forms IndexContents627 ASM 13, July 1999 Updated With Postal Bulletin Revisions Through October 7, 1999 Forms (cont d)Note.

5 All Forms listed with the citation Exhibit are those listed in Exhibit , RetentionPeriods for Post Office Forms , which begins on page List of Money Orders IssuedExhibit Control for Billing Accounts ReceivableExhibit and StatementExhibit Adjustment MemorandumExhibit to Flag Employee s AccountsExhibit s Work ScheduleExhibit Transaction RecordExhibit Transaction ConversionExhibit Transaction SurveyExhibit Security Clearance Processing , , , , Theft and Vandalism ComplaintExhibit 225, Exhibit Personnel , Exhibit Advance Request (Relocation Worksheet)Exhibit Building Pass Building Pass Personnel Security Employee Assignment NotificationExhibit Tort ClaimsExhibit for Loss Initial LetterExhibit for Accountable Financial LossExhibit s Claim for Personal PropertyExhibit and and Release BackgroundInvestigation (USPS Contractors & Employees ofContractors) Report Tort , Exhibit Time RecordExhibit , Leave, or Other Hours Adjustment RequestExhibit Pay or Leave Adjustment RequestExhibit Hours Adjustment RecordExhibit Evaluation Sheet (Space & Condition) 2 Performance Summary Mail VolumeExhibit and Forms IndexContents628 ASM 13, July 1999 Updated With Postal Bulletin Revisions Through October 7, 1999 Forms (cont d)Note.

6 All Forms listed with the citation Exhibit are those listed in Exhibit , RetentionPeriods for Post Office Forms , which begins on page 2 Performance Summary (Clerk MailhandlerWork Hours)Exhibit Statement of Employment and FinancialInterests (For Use by Postal Service Employees) Evaluation for EAS Employees General FormExhibit Evaluation for EAS Employees Supervisors and Managers EAS-19 and BelowExhibit Evaluation for EAS Employees Postmasters EAS-15 and BelowExhibit of Work AccomplishmentsExhibit RecordExhibit Training Record Supplement SheetExhibit NoticeExhibit for EmploymentExhibit , for Multidelivery StopExhibit Carrier Cost System FY 1991 Exhibit Verification RecordExhibit Verification for Second- and Fourth-ClassMatterExhibit Collections SummaryExhibit of Uncollected Customs ChargesExhibit for Customs Duty MailExhibit RecordExhibit of Applicant for Issuance of a Duplicate PostalCheck w/o Execution of Undertaking of IndemnityExhibit of Stamp Stock RequisitionsExhibit Service Accounts Receipts and WithdrawalsExhibit Transaction RecordExhibit for Temporary Schedule Change for PersonalConvenienceExhibit for Plain Stamped EnvelopesExhibit Receipt for Stamp Stock Submitted forRedemptionExhibit for Postal Cards Bulk QuantitiesExhibit and Forms IndexContents629 ASM 13, July 1999 Updated With Postal Bulletin Revisions Through October 7, 1999 Forms (cont d)Note.

7 All Forms listed with the citation Exhibit are those listed in Exhibit , RetentionPeriods for Post Office Forms , which begins on page for Forms 3216 (Requisition for Postal Cards Bulk Quantities)Exhibit for Stamped Envelope DiscountExhibit by MailExhibit Purchase OrderExhibit Allowance Cap DisbursementExhibit & Stamped Paper Destruction CertificateExhibit Deduction Authorization to Liquidate PostalService IndebtednessExhibit Deduction Authorization to Liquidate OtherGovernment Agency IndebtednessExhibit Allowance InquiryExhibit and Stamp Stock Count and SummaryExhibit Record of Stamps, Stamped Paper, andNonpostal Stamps on HandExhibit of Shipment/Stamp InvoiceExhibit and Philatelic Products Clerks Daily SalesRecordExhibit Requisition Bulk QuantitiesExhibit Credit Examination RecordExhibit Credit ReceiptExhibit Analysis ReportExhibit for Periodicals Mailing Privileges (General)Exhibit for Periodicals Mailing Privileges (NewsAgents or Foreign)Exhibit for Periodicals Mailing Privileges(Institutions and Societies)Exhibit of Deposits Made While Second-ClassApplication Is PendingExhibit for Saleable Items (Other than Stamps)Exhibit for Additional Entry, Reentry, or SpecialRate Request for Periodicals PublicationExhibit for Periodicals Mailing Privileges(Requestor)Exhibit of Ownership, Management and CirculationExhibit and Voucher for Refund of Postage andFeesExhibit and Forms IndexContents630 ASM 13, July 1999 Updated With Postal Bulletin Revisions Through October 7, 1999 Forms (cont d)Note.

8 All Forms listed with the citation Exhibit are those listed in Exhibit , RetentionPeriods for Post Office Forms , which begins on page Handling of Undeliverable PeriodicalsPublicationExhibit Certification for Multiple Issues (On theSame Day)Exhibit Certification for Multiple Issues (Not on theSame Day)Exhibit Statement Periodicals Nonprofit RatesExhibit Statement Periodicals Regular andScience of Agriculture RatesExhibit (Special) Record of Periodicals PostageExhibit Office Receipt for MoneyExhibit Order Change to Mailer of Correction in and Verification of CirculationExhibit of Returned MailExhibit OrderExhibit , , , Change-of-Address Order World Wide WebExhibit , Due BillExhibit Due InvoiceExhibit Due LogExhibit of Mailing with Metered or PrecanceledPostage Affixed First Class MailExhibit Statement First-Class Mail PermitImprintExhibit to Mail Without Affixing Postage StampsExhibit or Update for a License to Lease and UsePostage MetersExhibit Statement Nonprofit Standard Mail Permit ImprintExhibit , of Mailing Bulk RatesExhibit Collected Through Post Office MeterExhibit Statement Regular Standard Mail Permit ImprintExhibit for Postage Meter SettingsExhibit Revocation of Mailing Permit or Meter LicenseExhibit and Forms IndexContents631 ASM 13.

9 July 1999 Updated With Postal Bulletin Revisions Through October 7, 1999 Forms (cont d)Note: All Forms listed with the citation Exhibit are those listed in Exhibit , RetentionPeriods for Post Office Forms , which begins on page of Mailing with Meter Postage Affixed Priority Mail and Zone-Rated Fourth-Class MailExhibit Statement Priority Mail and Zone-RatedStandard Mail (B) Permit ImprintExhibit of Permit Imprint MailingsExhibit for Post Office MeterExhibit of Postage Meter SettingsExhibit of PermitExhibit of Quarterly Verification of Metered MailExhibit Setting of Postage Meter Licensed at AnotherOfficeExhibit Number RecordExhibit to Use Precanceled Stamps or GovernmentPrecanceled Stamped Envelopes ApplicationExhibit for Nonprofit Standard Mail Rates atAdditional Mailing OfficeExhibit to Mail at Special Bulk Third-Class RatesExhibit Return Permit ApplicationExhibit Statement International Surface Air LiftExhibit Statement International Permit Imprint Mailor Bulk Letters to Canada with Permit ImprintExhibit Statement International Priority AirmailExhibit SurveyExhibit Mailing Record (Collection and Special TestMailings)

10 Exhibit WatchExhibit Mail Report All Post OfficesExhibit in the Preparation of Mail MatterExhibit Delivery OrderExhibit by a Hotel, Apartment House, or the Liketo Assume Responsibility for Registered MailExhibit for Registered MailExhibit Authorization, Application, Worksheet, andAgreementExhibit Mailing and Delivery ReceiptExhibit ReceiptExhibit Tag TransmittalExhibit and Forms IndexContents632 ASM 13, July 1999 Updated With Postal Bulletin Revisions Through October 7, 1999 Forms (cont d)Note: All Forms listed with the citation Exhibit are those listed in Exhibit , RetentionPeriods for Post Office Forms , which begins on page Irregularity ReportExhibit Report of Insured and COD MailExhibit Dispatch RecordExhibit Office Record of ClaimExhibit Verification of CirculationExhibit Notification/Reminder/ReceiptExhibit Registry Dispatch BookExhibit Mail Dispatch Bill (1850/carton)Exhibit Loss Claim Filed by SenderExhibit ClaimExhibit Claim Filed by SenderExhibit Claim Filed by AddresseeExhibit Mail Matter Received for DeliveryExhibit Verification Insured and Returned CODMailExhibit Mailing Book for Accountable MailExhibit Delivery BookExhibit Delivery Receipt (1600/carton)