Sample PS Form 3813 "Insured Mail Receipt '" Domestic Only '" $500 and Under"

What Is PS Form 3813?

This is a legal form that was released by the U.S. Postal Service (USPS) on April 1, 2015 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2015;
  • The latest available edition released by the U.S. Postal Service (USPS);
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of PS Form 3813 by clicking the link below or browse more documents and templates provided by the U.S. Postal Service (USPS).

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Download Sample PS Form 3813 "Insured Mail Receipt '" Domestic Only '" $500 and Under"

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DOMESTIC ONLY
®
$500 and under
U.S. Postal Service
INSURED MAIL RECEIPT
Special Handling, No Fee
Special Handling, No Fee
Special Handling, With Fee
(check box)
(check box)
Perishable
Fragile
$_________
Hazardous Material Transportation
Live Animal Transportation $_________
Insurance Fee
Insurance Coverage
$
Signature Confirmation™ Fee
$
Signature Confirmation™ Restricted Delivery Fee
Postmark
Here
$
Postage
$
Total Postage and Fees
$
Sent To
Street and Apt. No., or PO Box No.
City, State, ZIP+4
®
PS Form 3813, April 2015
See Reverse for Instructions
PSN 7530-02-000-9056
DOMESTIC ONLY
®
$500 and under
U.S. Postal Service
INSURED MAIL RECEIPT
Special Handling, No Fee
Special Handling, No Fee
Special Handling, With Fee
(check box)
(check box)
Perishable
Fragile
$_________
Hazardous Material Transportation
Live Animal Transportation $_________
Insurance Fee
Insurance Coverage
$
Signature Confirmation™ Fee
$
Signature Confirmation™ Restricted Delivery Fee
Postmark
Here
$
Postage
$
Total Postage and Fees
$
Sent To
Street and Apt. No., or PO Box No.
City, State, ZIP+4
®
PS Form 3813, April 2015
See Reverse for Instructions
PSN 7530-02-000-9056
INSURANCE RECEIPT ($500 AND UNDER)
SAVE THIS RECEIPT UNTIL THE PACKAGE IS ACCOUNTED FOR
INSURANCE COVERAGE: Insurance is provided only in accordance with postal regulations in the Domestic
Mail Manual (DMM®). The DMM sets forth the specific types of coverage, terms of insurance and conditions of payment.
The DMM is available online at http://pe.usps.gov. Limitations on coverage include, but are not limited to the following:
Coverage extends to the lesser of: actual (depreciated) value of the contents at the time of mailing, cost of repairs, or
the limit fixed for the insurance coverage obtained.
No coverage is provided for articles improperly packaged or too fragile to withstand normal handling, concealed
damage, spoilage of perishable items, prohibited articles, consequential losses or delay.
Other limitations are set forth in the DMM. Coverage, terms and limitations are subject to change.
Filing a Claim
Claim for loss: File a claim no sooner than 15 days but no later than 60 days from the mailing date — for an
APO/FPO/DPO item, file no sooner than 45 days and no later than 1 year from the mailing date. Retain the original
mailing receipt and proof of value.
Claim for damage or missing contents: File a claim immediately but no later than 60 days from the mailing date.
Retain the original mailing receipt and proof of value, and also retain the article and mailing container.
Please file your domestic claim online at www.usps.com/domestic-claims. If you are unable to file online, call toll
free 800-275-8777 for additional information.
Important: Save this receipt and present it when making a claim.
3813
PS Form
, April 2015 (Reverse) PSN 7530-02-000-9056
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