PS Form 5436 "Mailing List Application- Mail Transportation Services"

What Is PS Form 5436?

This is a legal form that was released by the U.S. Postal Service (USPS) on October 1, 2010 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2010;
  • 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;

Download a printable version of PS Form 5436 by clicking the link below or browse more documents and templates provided by the U.S. Postal Service (USPS).

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Download PS Form 5436 "Mailing List Application- Mail Transportation Services"

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Mailing List Application—
Mail Transportation Services
In order for us to know the type of service and equipment you are interested in providing, please print or type the
information requested below and return the form to the contracting officer at the Distribution Networks Office in the
area where you currently reside. Upon receipt of the completed form, your name will be placed on our list of persons
and companies interested in submitting bids or proposals to transport mail under contract with the United States
Postal Service ® .
I. Applicant Information
Last Name or Trade Name
First Name
Middle Name
Attention To:
Mailer ID
Mailing Address
DOT
ZIP + 4 ®
City
State
-
County
Email
Business Telephone
Residence Telephone
Social Security or
Tax ID No.
-
-
-
-
Privacy Notice: Your information will be used to provide you requested products, services, or information. Collection is authorized by
39 USC 401, 403, & 404.
Providing the information is voluntary, but if not provided, we may not process your request. We do not disclose your information
without your consent to third parties, except to facilitate the request, to act on your behalf or request, or as legally required. This
includes the following limited circumstances: to a congressional office on your behalf; to financial entities regarding financial transaction
issues; to a USPS ® auditor; to entities, including law enforcement, as required by law or in legal proceedings; and to contractors and
other entities aiding us to fulfill the service (service providers).
II. Type of Business Organization (Check applicable items only. “See the Supplying Principles and Practices,
section Define Supplier Diversity Objectives for definitions."
Minority-Owned Business (Check one if applicable)
Small Business Concern
Woman-Owned Business
Black American
Asian-Pacific American
Labor Surplus Area Concern
Hispanic American
Asian-Indian American
Educational or Other Non-Profit Organization
Native American
5436
, October 2010 (Page 1 of 2)
PS Form
Mailing List Application—
Mail Transportation Services
In order for us to know the type of service and equipment you are interested in providing, please print or type the
information requested below and return the form to the contracting officer at the Distribution Networks Office in the
area where you currently reside. Upon receipt of the completed form, your name will be placed on our list of persons
and companies interested in submitting bids or proposals to transport mail under contract with the United States
Postal Service ® .
I. Applicant Information
Last Name or Trade Name
First Name
Middle Name
Attention To:
Mailer ID
Mailing Address
DOT
ZIP + 4 ®
City
State
-
County
Email
Business Telephone
Residence Telephone
Social Security or
Tax ID No.
-
-
-
-
Privacy Notice: Your information will be used to provide you requested products, services, or information. Collection is authorized by
39 USC 401, 403, & 404.
Providing the information is voluntary, but if not provided, we may not process your request. We do not disclose your information
without your consent to third parties, except to facilitate the request, to act on your behalf or request, or as legally required. This
includes the following limited circumstances: to a congressional office on your behalf; to financial entities regarding financial transaction
issues; to a USPS ® auditor; to entities, including law enforcement, as required by law or in legal proceedings; and to contractors and
other entities aiding us to fulfill the service (service providers).
II. Type of Business Organization (Check applicable items only. “See the Supplying Principles and Practices,
section Define Supplier Diversity Objectives for definitions."
Minority-Owned Business (Check one if applicable)
Small Business Concern
Woman-Owned Business
Black American
Asian-Pacific American
Labor Surplus Area Concern
Hispanic American
Asian-Indian American
Educational or Other Non-Profit Organization
Native American
5436
, October 2010 (Page 1 of 2)
PS Form
III. Type of Equipment (Check applicable items only)
0. Passenger Car or Station Wagon
4. Heavy Truck (900 cubic feet and above)
8. Ship (Ocean transportation)
1. Pickup Truck/Van (100-250 cubic feet)
5. Tractor-Trailer
9. Aircraft (FAR 135)
2. Light Truck (251-499 cubic feet)
6. Motive Power (Tractor units only)
10. Aircraft (FAR 121)
3. Medium Truck (500-899 cubic feet)
7. Boat
IV. Type of Route/Contract
Please indicate the type of operation you are interested in (as explained below) by checking ONLY the boxes applicable to your
operation
.
A. CDS Delivery
C. Water
E. Freight
G. Trailer Services
B. Highway (trucks)
D. Air
F. One-Way Service
A. CDS Delivery — Routes that provide for delivery and collection of mail from homes and businesses.
Individuals: An individual must be at least 21 years of age and able to work legally in the United States. A partnership is
qualified if any partner meets the foregoing qualifications of an individual.
B. Highway — Routes that involve the transport of mail between points designated by the United States Postal Service ® and
do not include CDS delivery service.
C. Water — Routes that involve the transport of mail over water between points designated by the United States Postal
Service.
D. Air — Routes that involve the transport of mail by aircraft between points designated by the United States Postal Service.
Air carriers must possess the mandatory FAR certification for the size and type of equipment required.
E. Freight — Non-Mail Service. Covers all items other than mail.
F. One-Way Services — Mail Transport Equipment and other mail as directed by Distribution Network Office.
G. Trailer Services — Leased and assigned to Bulk Mail Centers and Processing Centers for short and long term use based
on needs of the Area Distribution Networks offices.
V. Areas of Operation
The following is a list of state codes for specified route types. Please indicate ONLY the areas in which you wish to operate by
checking the appropriate box(es).
AL - Alabama
GA - Georgia
MD - Maryland
NJ - New Jersey
SC - South Carolina
AK - Alaska
HI - Hawaii
MA - Massachusetts
NM - New Mexico
SD - South Dakota
AZ - Arizona
ID - Idaho
MI - Michigan
NY - New York
TN - Tennessee
MN - Minnesota
NC - North Carolina
TX - Texas
AR - Arkansas
IL - Illinois
CA - California
IN - Indiana
MS - Mississippi
ND - North Dakota
UT - Utah
CO - Colorado
IA - Iowa
MO - Missouri
OH - Ohio
VT - Vermont
CT - Connecticut
KS - Kansas
MT - Montana
OK - Oklahoma
VA - Virginia
DE - Delaware
KY - Kentucky
NE - Nebraska
OR - Oregon
WA - Washington
DC - District of Columbia
LA - Louisiana
NV - Nevada
PA - Pennsylvania
WV - West Virginia
FL - Florida
ME - Maine
NH - New Hampshire
PR - Puerto Rico
WI - Wisconsin
WY - Wyoming
RI - Rhode Island
NOTE: Should any of the information change or you no longer wish to receive advertisements, please notify the contracting
officer at your area Distribution Networks Office so they may correct the mailing list accordingly.
5436
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PS Form
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