Sample PS Form 3816 "Collect on Delivery (Cod) Mailing and Delivery Receipt"

What Is PS Form 3816?

This is a legal form that was released by the U.S. Postal Service (USPS) on January 1, 2016 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2016;
  • 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 3816 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 3816 "Collect on Delivery (Cod) Mailing and Delivery Receipt"

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DELIVERY EMPLOYEE - Remove Copies 1 & 2 at Time of Delivery
Write firmly to make all copies legible.
Collect the amount shown below if the customer pays by:
CHECK OR MONEY
CASH or pin debit card and
CASH
(includes
ORDER (MO)
made
mailer is an EFT participant
MO fee or fees).
payable to the mailer.
(online or commercial only).
Check/MO
EFT
Cash
$
$
$
Check
COD
(if applicable)
Options for Receiving
Registered Mail
Service
Priority Mail Express
Service
®
Remit COD Charges
Priority Mail
Electronic Funds
Hold For Pickup
to Sender via:
Express Service
Transfer (EFT)
(Priority Mail Express Only)
Date of
USPSCA
Street Delivery
SAMPLE
Mailing
Number
From:
To:
Delivered By
Date Delivered
Check Number
Date Payment Sent to Mailer
MO Number(s)
3816
PS Form
, January 2016 PSN 7530-02-000-9062
Copy 1 - Delivery Unit
1. DO NOT allow the recipient (addressee or agent) to examine the contents before payment.
3. If payment is by check, enter check number above.
2. DO NOT deliver this article until payment is collected.
4. Have customer sign PS Form 3849.
Follow proper scanning procedures for COD delivery and clearance.
DELIVERY EMPLOYEE - Remove Copies 1 & 2 at Time of Delivery
Write firmly to make all copies legible.
Collect the amount shown below if the customer pays by:
CHECK OR MONEY
CASH or pin debit card and
CASH
(includes
ORDER (MO)
made
mailer is an EFT participant
MO fee or fees).
payable to the mailer.
(online or commercial only).
Check/MO
EFT
Cash
$
$
$
Check
COD
(if applicable)
Options for Receiving
Registered Mail
Service
Priority Mail Express
Service
®
Remit COD Charges
Priority Mail
Electronic Funds
Hold For Pickup
to Sender via:
Express Service
Transfer (EFT)
(Priority Mail Express Only)
Date of
USPSCA
Street Delivery
SAMPLE
Mailing
Number
From:
To:
Delivered By
Date Delivered
Check Number
Date Payment Sent to Mailer
MO Number(s)
3816
PS Form
, January 2016 PSN 7530-02-000-9062
Copy 1 - Delivery Unit
1. DO NOT allow the recipient (addressee or agent) to examine the contents before payment.
3. If payment is by check, enter check number above.
2. DO NOT deliver this article until payment is collected.
4. Have customer sign PS Form 3849.
Follow proper scanning procedures for COD delivery and clearance.
Mail payment for only one COD per envelope
Check/MO
EFT
Cash
$
$
$
COD
DELIVERY EMPLOYEE: Turn in this copy with the
payment you received for the COD article and the signed
PS Form 3849. Be sure the COD number appears on
the money order(s) or check.
SAMPLE
To:
From:
POST OFFICE: Return this copy to the mailer* with the money order(s), check, or receipt for
electronic funds transfer. Mail payment for only one COD per EMO4 envelope (mailer address
will appear in the window). Please secure this copy in the envelope with tape, if necessary.
*Exception: DO NOT return this copy to an EFT mailer.
3816
PS Form
, January 2016 PSN 7530-02-000-9062
Copy 2 - Payment
SAVE THIS RECEIPT
See reverse side for claims and EFT information.
Check/MO
EFT
Cash
$
$
$
Check
COD
(if applicable)
Options for Receiving
Registered Mail
Service
Priority Mail Express
Service
®
Date of Mailing
Hold For Pickup
(Priority Mail Express Only)
Street Delivery
SAMPLE
From:
To:
Check
COD Fee
Extra Service
Postmark
(if applicable)
Return Receipt hardcopy
Signature Confirmation Restricted Delivery
Fee
Return Receipt Electronic
Adult Signature Required
Signature Confirmation
Adult Signature Restricted Delivery
Postage
Total Postage
Special Handling
Check
& Fees
(if applicable)
Fragile
Perishable
Hazardous Materials
Live Animals
3816
PS Form
, January 2016 PSN 7530-02-000-9062
Copy 3 - Mailer
Instructions for Collect on Delivery (COD) Service
The fees for COD service include the
NOTES:
Filing a Claim
following:
Checks and money orders must be made
Claim for loss: File a claim no sooner than
payable to the mailer.
15 days but no later than 60 days from the
Insurance against loss, damage, or
mailing date. Retain the original mailing
missing contents. (Coverage may not
Postmasters will not participate in
receipt and proof of value.
exceed the limit for the insurance fee
disputes regarding the recipient’s check or
paid.)
money order.
Claim for damage or missing contents:
File a claim immediately but no later than
SAMPLE
Collection of COD payment is by cash,
Hold For Pickup service is available at the
60 days from the mailing date. Retain the
money order, or the recipient’s check
time of mailing and allows a designated
original mailing receipt and proof of value,
made payable to the mailer. The USPS
Post Office location to hold mailpieces
and also retain the article and mailing
forwards the check or money order to
for pickup by a specified addressee or
container.
the mailer. If payment is made by cash, a
designee.
money order fee is included in the amount
Please file your domestic claim online at
Either the mailer or the addressee may file
collected from the recipient, unless the
www.usps.com/domestic-claims. If you
a claim.
mailer (online or commercial only) is
are unable to file online, call toll free
authorized to participate in electronic
800-275-8777 for additional information.
The following items must accompany each
funds transfer (EFT) for the remittance.
claim:
For more information on claims, see
See DMM 503 at http://pe.usps.gov for
Publication 122, Customer Guide to Filing
limitations.
Proof of value.
Domestic Insurance Claims or Registered
Services offered with COD are Priority
Evidence of insurance (original mailing
Mail Inquiries, at http://about.usps.com/
Mail Express®, Priority Mail®, First-Class
publications/pub122.pdf.
receipt).
Mail®, First-Class Package Service®,
USPS Retail Ground™, Parcel Select®,
Bound Printed Matter, Media Mail®, and
Library Mail.
3816
Reverse of Copy 3 - Mailer
PS Form
, January 2016 PSN 7530-02-000-9062
Retain at Mailing Post Office
Check/MO
EFT
Cash
$
$
$
Check
COD
(if applicable)
Options for Receiving
Registered Mail
Service
Priority Mail Express
Service
®
Date of Mailing
Hold For Pickup
(Priority Mail Express Only)
Street Delivery
SAMPLE
From:
To:
Check
COD Fee
Extra Service
Postmark
(if applicable)
Return Receipt hardcopy
Signature Confirmation Restricted Delivery
Fee
Return Receipt Electronic
Adult Signature Required
Signature Confirmation
Adult Signature Restricted Delivery
Postage
Total Postage
Special Handling
Check
& Fees
(if applicable)
Fragile
Perishable
Hazardous Materials
Live Animals
3816
PS Form
, January 2016 PSN 7530-02-000-9062
Copy 4 - Mailing P.O.
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