PS Form 3624 "Application to Mail at Nonprofit USPS Marketing Mail Prices"

What Is PS Form 3624?

PS Form 3624, Application to Mail at Nonprofit USPS Marketing Mail Prices - also known as the USPS Form 3624 - is a form used for applying for an authorization to mail at lower prices at the post office. The United States Postal Service (USPS) allows nonprofit organizations to apply for postal service nonprofit privileges. Typically, these organizations are educational, religious, scientific, philanthropic, agricultural, and labor. Individuals cannot apply to mail at nonprofit prices, just like chambers of commerce, social clubs, business leagues, and certain political organizations. The nonprofit standard mail prices represent a tangible benefit to eligible mailers in comparison with regular standard mail prices.

You must submit the required documentation with your application to support your claim to mail at nonprofit prices:

  1. Formative papers - for example, a constitution, a charter, articles of incorporation, trust indenture, or another organizing instrument;
  2. A letter from the Internal Revenue Service that proves the exemption from paying the federal income tax;
  3. Other evidence of the organization's nonprofit status. It may be a financial statement written by a certified public accountant that substantiates nonprofit status. That statement has to include an income statement, balance sheets, notes, etc. Internal financial statements are not sufficient;
  4. Documents of operation - list of activities, minutes of meetings, brochures, bulletins, annual reports.

The latest version of the form was released on January 1, 2017, with all previous editions obsolete. A printable PS Form 3624 can be downloaded below or requested from your postmaster. As of today, no PS Form 3624 fillable copies are available online.

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PS Form 3624 and 3623

The PS Form 3623 (Request for Confirmation of Authorization (or Pending Application) to Mail at Nonprofit USPS Marketing Mail Prices) is a related form used to confirm that the applicant has filed PS Form 3624 and is waiting for the authorization to mail at lower prices. It is issued only to the organization that possesses the original authorization or that has applied for it. The completed request must be submitted at the post office where the confirmation is needed.

If the organization has nonprofit authorization at one USPS location, it automatically receives authorization at all locations. However, only locations with access to the PostalOne! System - an information management system designed exclusively for business mailers - can confirm this authorization.

Where to Submit PS Form 3624 Online?

If you do not want or cannot submit the completed PS 3624 and the required documentation to your postmaster, you can send it via Business Mail Entry Unit. Applications are accepted online if you obtain a login and password at Business Customer Gateway. You need to enter the zip code of the post office on the Post Office of the application page. On the general information page, enter the necessary information and choose a type of a nonprofit organization. On the supporting documentation page, select the supporting documents you are supplying. Make sure you have a paper version of the documents that must be presented in person at the post office that will accept your mailings. After that, you need to review all the changes, certify the information is correct and true, then submit the form.

If the documentation is correct and complete, the review process usually takes two weeks. Once your organization is approved to mail at nonprofit privileges, to keep that authorization active, you have to make a nonprofit mailing at least once in two years. Otherwise, your authorization may be revoked.

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Download PS Form 3624 "Application to Mail at Nonprofit USPS Marketing Mail Prices"

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Page background image
Application to Mail at
Nonprofit USPS Marketing Mail Prices
Application Number:
Section A - Application (Please read section B on page 2 before completion.)
Part 1 (For completion by applicant)
ƒ All information entered below must be legible so that our records
ƒ The applicant named in item 7 must be the individual submitting the application for
will show the correct information about your organization.
the organization and must be a responsible official of the organization. Printers and
mailing agents may not sign for the organization.
ƒ The complete name of the organization must be shown in item 1.
The name shown must agree with the name that appears on all
ƒ No additional organization categories may be added in item 9. To be eligible for the
documents submitted to support this application.
Nonprofit USPS Marketing Mail prices, the organization must qualify as one of the
types listed.
ƒ A complete address representing a physical location for the
organization must be shown in item 2. If you receive mail through a
ƒ The applicant must sign the application in item 15.
Post Office™ box, show your street address first and use alternate
ƒ The application must be submitted to the Post Office in item 14 and on the date
address for the box.
shown in item 17.
.)
No application fee is required. (All information must be complete and typewritten or printed legibly
1. Complete Name of Organization (If voting registration official, include title)
2. Street Address of Organization (Include apartment or suite number)
3. City, State, ZIP+4
®
Code
5. Alternate City, State, ZIP+4
®
Code
4. Alternate Mailing Address
6. Telephone (Include area code)
7. Name of Applicant (Must represent applying organization)
8. Email Address
9. Type of Organization (Check only one)
(09) Qualified political committee
(01) Religious
(03) Scientific
(05) Agricultural
(07) Veterans
(Go to item 12)
(10) Voting registration official
(02) Educational
(04) Philanthropic
(06) Labor
(08) Fraternal
(Go to item 12)
Not all nonprofit organizations are eligible for the Nonprofit USPS Marketing Mail prices. Domestic Mail Manual® 703.1 lists certain organizations (such
as business leagues, chambers of commerce, civic improvement associations, social and hobby clubs, governmental bodies, and others) that, although
nonprofit, do not qualify for the Nonprofit USPS Marketing Mail prices.
10. Is this a for-profit organization or does any of the net income
12. Has this organization previously mailed at the Nonprofit USPS
Yes
Yes
inure to the benefit of any private stockholder or individual?
Marketing Mail prices? (If `Yes,’ list the Post Office locations
where mailings were most recently deposited at these prices
No
No
and provide the nonprofit authorization number, if known.)
11. Is this organization exempt from federal income tax? (If
Yes
‘Yes,’ attach a copy of the exemption issued by the Internal
Revenue Service (IRS) that shows the section of the IRS
No
code under which the organization is exempt. Required if
13. Has your organization had Nonprofit USPS Marketing Mail
exempt. Do not submit State tax exemption information.)
Yes
Yes
privileges denied or revoked? (If `Yes,’ list the Post Office (city
Has the IRS denied or revoked the organization’s federal tax
and state) where the application was denied or authorization
exempt status? (If `Yes,’ attach a copy of the IRS ruling to
No
was revoked and provide the nonprofit authorization number, if
No
this PS Form 3624.)
known.)
From your IRS exemption letter, check off the box corresponding
to the section under which the organization is exempt:
501(c)(3)
501(c)(5)
14. Post Office (not a station or branch) where authorization requested
501(c)(8)
501(c)(19)
and bulk mailings will be made (City, state, ZIP Code™).
Other 501(c) (
) (See statement in item 9 above)
I certify that the statements made by me are true and complete. I understand
application is approved, a postage refund for the difference between the regular
that anyone who furnishes false or misleading information on this form or
USPS Marketing Mail and Nonprofit USPS Marketing Mail prices may be made
who omits material information requested on the form may be subject to
for only mailings entered at regular USPS Marketing Mail prices at the Post Office
criminal sanctions (including fines and imprisonment) and/or civil sanctions
identified above while this application is pending, provided that the conditions set forth
(including multiple damages and civil penalties). I further understand that, if this
in Domestic Mail Manual 703.1 and 703.1.9 are met.
15. Signature of Applicant
16. Title
17. Date
Part 2 (For completion by postmaster at originating office when application filed)
1. Signature of Postmaster (Or designated representative)
2. Date Application Filed With Post Office (Round stamp)
3624,
PRIVACY NOTICE: See our privacy policy on www.usps.com
PS Form
January 2017 (Page 1 of 3) PSN 7530-02-000-9014
Application to Mail at
Nonprofit USPS Marketing Mail Prices
Application Number:
Section A - Application (Please read section B on page 2 before completion.)
Part 1 (For completion by applicant)
ƒ All information entered below must be legible so that our records
ƒ The applicant named in item 7 must be the individual submitting the application for
will show the correct information about your organization.
the organization and must be a responsible official of the organization. Printers and
mailing agents may not sign for the organization.
ƒ The complete name of the organization must be shown in item 1.
The name shown must agree with the name that appears on all
ƒ No additional organization categories may be added in item 9. To be eligible for the
documents submitted to support this application.
Nonprofit USPS Marketing Mail prices, the organization must qualify as one of the
types listed.
ƒ A complete address representing a physical location for the
organization must be shown in item 2. If you receive mail through a
ƒ The applicant must sign the application in item 15.
Post Office™ box, show your street address first and use alternate
ƒ The application must be submitted to the Post Office in item 14 and on the date
address for the box.
shown in item 17.
.)
No application fee is required. (All information must be complete and typewritten or printed legibly
1. Complete Name of Organization (If voting registration official, include title)
2. Street Address of Organization (Include apartment or suite number)
3. City, State, ZIP+4
®
Code
5. Alternate City, State, ZIP+4
®
Code
4. Alternate Mailing Address
6. Telephone (Include area code)
7. Name of Applicant (Must represent applying organization)
8. Email Address
9. Type of Organization (Check only one)
(09) Qualified political committee
(01) Religious
(03) Scientific
(05) Agricultural
(07) Veterans
(Go to item 12)
(10) Voting registration official
(02) Educational
(04) Philanthropic
(06) Labor
(08) Fraternal
(Go to item 12)
Not all nonprofit organizations are eligible for the Nonprofit USPS Marketing Mail prices. Domestic Mail Manual® 703.1 lists certain organizations (such
as business leagues, chambers of commerce, civic improvement associations, social and hobby clubs, governmental bodies, and others) that, although
nonprofit, do not qualify for the Nonprofit USPS Marketing Mail prices.
10. Is this a for-profit organization or does any of the net income
12. Has this organization previously mailed at the Nonprofit USPS
Yes
Yes
inure to the benefit of any private stockholder or individual?
Marketing Mail prices? (If `Yes,’ list the Post Office locations
where mailings were most recently deposited at these prices
No
No
and provide the nonprofit authorization number, if known.)
11. Is this organization exempt from federal income tax? (If
Yes
‘Yes,’ attach a copy of the exemption issued by the Internal
Revenue Service (IRS) that shows the section of the IRS
No
code under which the organization is exempt. Required if
13. Has your organization had Nonprofit USPS Marketing Mail
exempt. Do not submit State tax exemption information.)
Yes
Yes
privileges denied or revoked? (If `Yes,’ list the Post Office (city
Has the IRS denied or revoked the organization’s federal tax
and state) where the application was denied or authorization
exempt status? (If `Yes,’ attach a copy of the IRS ruling to
No
was revoked and provide the nonprofit authorization number, if
No
this PS Form 3624.)
known.)
From your IRS exemption letter, check off the box corresponding
to the section under which the organization is exempt:
501(c)(3)
501(c)(5)
14. Post Office (not a station or branch) where authorization requested
501(c)(8)
501(c)(19)
and bulk mailings will be made (City, state, ZIP Code™).
Other 501(c) (
) (See statement in item 9 above)
I certify that the statements made by me are true and complete. I understand
application is approved, a postage refund for the difference between the regular
that anyone who furnishes false or misleading information on this form or
USPS Marketing Mail and Nonprofit USPS Marketing Mail prices may be made
who omits material information requested on the form may be subject to
for only mailings entered at regular USPS Marketing Mail prices at the Post Office
criminal sanctions (including fines and imprisonment) and/or civil sanctions
identified above while this application is pending, provided that the conditions set forth
(including multiple damages and civil penalties). I further understand that, if this
in Domestic Mail Manual 703.1 and 703.1.9 are met.
15. Signature of Applicant
16. Title
17. Date
Part 2 (For completion by postmaster at originating office when application filed)
1. Signature of Postmaster (Or designated representative)
2. Date Application Filed With Post Office (Round stamp)
3624,
PRIVACY NOTICE: See our privacy policy on www.usps.com
PS Form
January 2017 (Page 1 of 3) PSN 7530-02-000-9014
Section B—General Information
Organization Eligibility
The Nonprofit USPS Marketing 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 USPS Marketing 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 USPS Marketing 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 USPS Marketing 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:
ƒ An Internal Revenue Service (IRS) letter of exemption from payment of federal income tax.
ƒ 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:
ƒ 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.
ƒ 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 USPS Marketing Mail prices may mail only its own matter at those
prices. It may not delegate or lend the use of its Nonprofit USPS Marketing Mail authorization to any other person
or organization. Cooperative mailings may be made at the Nonprofit USPS Marketing 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.
3624,
PS Form
January 2017 (Page 2 of 3)
Postal Service™ Checklist for PS Form 3624,
Application to Mail at Nonprofit USPS Marketing Mail Prices
Name of Organization
The organization above provided the following evidence of eligibility for Nonprofit USPS Marketing 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.)
Articles of Incorporation
Articles of Association
Charter
Constitution
Enabling Legislation
Trust Indenture
Other (Explain):
3. Operation (Several samples of each; check types of information included with application)
Listing of activities for past 6 to
Bulletins
Financial statements
Brochures
12 months
Membership applications
Minutes of meetings
Newsletters
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
Signature of Postmaster (Or designated representative)
Date
Telephone (Include area code)
Post Office (City, state, ZIP Code™)
Date Application Returned to Organization for Correction
Date Application and Documentation Sent to Pricing and Classification
Service Center
3624,
PS Form
January 2017 (Page 3 of 3) PSN 7530-02-000-9014
PRIVACY NOTICE: See our privacy policy on www.usps.com
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