PS Form 5541 Pickup Service Statement Priority Mail Express, Global Express Guaranteed, Priority Mail, or Standard Post

PS form EIB-SBA5541 or the "Pickup Service Statement Priority Mail Express, Global Express Guaranteed, Priority Mail, Or Standard Post" is a form issued by the U.S. Postal Service (USPS).

Download a PDF version of the PS Form EIB-SBA5541 down below or find it on the U.S. Postal Service (USPS) Forms website.

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Pickup Service Statement
Priority Mail Express, Global Express Guaranteed, Priority Mail, or Standard Post
1. Customer Information
2. Product Information
Customer Name
Quantity
Company Name
Priority Mail Express
Address 1
Global Express Guaranteed
®
Address 2
Priority Mail
®
City
Standard Post
(Domestic or International)
State
ZIP+4
®
Estimated total weight
of all packages
(In pounds)
3. Payment Method
4. Affix Stamps or Meter Strip Here
(If applicable)
Check made payable to
Merchandise Return
“Postmaster”
Label
USPS Corporate Account No.
Postage Due Account
or Federal Agency No.:
Stamps or Metered
Postage (Affix at right)
5. Customer Signature
6. USPS
®
Signature
7. Date & Time of Pickup
5541,
1 - Finance
2 - Customer
PS Form
July 2013
Pickup Service Statement
Priority Mail Express, Global Express Guaranteed, Priority Mail, or Standard Post
1. Customer Information
2. Product Information
Customer Name
Quantity
Company Name
Priority Mail Express
Address 1
Global Express Guaranteed
®
Address 2
Priority Mail
®
City
Standard Post
(Domestic or International)
State
ZIP+4
®
Estimated total weight
of all packages
(In pounds)
3. Payment Method
4. Affix Stamps or Meter Strip Here
(If applicable)
Check made payable to
Merchandise Return
“Postmaster”
Label
USPS Corporate Account No.
Postage Due Account
or Federal Agency No.:
Stamps or Metered
Postage (Affix at right)
5. Customer Signature
6. USPS
®
Signature
7. Date & Time of Pickup
5541,
1 - Finance
2 - Customer
PS Form
July 2013
Instructions
Completed by the Postal Service
Employee:
1. Customer Information: Enter customer name (if applicable), address, suite number, city, state, and ZIP + 4
where pickup is requested. If the ZIP + 4 is not known, enter the ZIP Code
.
2. Product Information: Enter the quantity of each product to be picked up, and enter the estimated weight in
pounds for all products.
3. Payment Method: Indicate the method of payment for pickup service. Be sure to include the account number
where applicable.
Completed by the Customer:
4. Affix Stamps or Meter Strip Here: If applicable.
5. Customer Signature.
Completed by the Postal Service Employee:
6. This space is for the signature of the Postal Service employee who picks up the mailpiece(s).
7. The Postal Service employee enters the date, time, and place of the pickup.
Note to the Postal Service Employee: Provide the customer with part 2 (the “Customer” copy) and return part 1
(the “Finance” copy) to the office for processing.
5541,
PS Form
July 2013 (Reverse)

Download PS Form 5541 Pickup Service Statement Priority Mail Express, Global Express Guaranteed, Priority Mail, or Standard Post

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