HomeMy WebLinkAbout20250909_33459_FIRMBOOK_20250910001145Shipment ConfirmationAcceptance Notice
Shipment Date: _______________________________________________
Shipped From:
Name: _______________________________________________
Address: _______________________________________________
City: _______________________________________________
State: _______ ZIP+4® _______________________________
Note to Mailer: The labels and volume associated to
this form online, must match the labeled packages being
presented to the USPS® employee with this form.
Type of Mail Volume
Priority Mail Express®*
Priority Mail®
First-Class Package Service®
Returns
International*
Other
Total
*Start time for products with service guarantees will begin when mail arrives at the local Post Office™ and
items receive individual processing and acceptance scans.
B. USPS Action
A. Mailer Action
USPS EMPLOYEE: Please scan upon pickup or receipt of mail.
Leave form with customer or in customer’s mail receptacle.
PS Form 5630, September 2016 PSN 7530-08-000-4335
09/09/2025
CITY OF LAKE ELSINORE
130 S MAIN STREET
LAKE ELSINORE
CA 92530
1
1
Note to RSS Clerk:
1. Home screen > Mailing/Shipping > More
2. Select Shipment Confirm
3. Scan or enter the barcode/label number from PS Form 5630
4. Confirm the volume count message by selecting Yes or No
5. Select Pay and End Visit to complete transaction
USPS SCAN AT ACCEPTANCE
92750901193562000064377369
9275 0901 1935 6200 0064 3773 69
Name and Address of Sender Check type of mail or service
Affix Stamp Here
(for additional copies of this receipt).
Postmark with Date of Receipt.
£ Adult Signature Required £ Priority Mail Express
£ Adult Signature Restricted Delivery £ Registered Mail
£ Certified Mail £ Return Receipt for
Merchandise£ Certified Mail Restricted Delivery
£ Collect on Delivery (COD)£ Signature Confirmation
£ Insured Mail
£ Priority Mail
£ Signature Confirmation
Restricted Delivery
USPS Tracking/Article Number Addressee (Name, Street, City, State, & ZIP Code™)Postage (Extra
Service)
Fee
Handling
Charge
Actual Value
if Registered
Insured
Value
Due
Sender if
COD
ASR
Fee
ASRD
Fee
RD
Fee
RR
Fee
SC
Fee
SCRD
Fee
SH
Fee
Total Number of Pieces
Listed by Sender
Total Number of Pieces
Received at Post Office
Postmaster, Per (Name of receiving employee)
PS Form 3877, January 2017
PSN 7530-02-000-9098
Complete in Ink Privacy Notice: For more information on USPS privacy policies, visit usps.com/privacypolicy.
Firm Mailing Book For Accountable Mail
Adult Signature RequiredAdult Signature Restricted DeliveryRestricted DeliveryReturn ReceiptHandling Charge - if Registered and over $50,000 in valueSignature Confirmation Restricted DeliverySpecial HandlingSignature ConfirmationCITY OF LAKE ELSINORE
130 S. MAIN STREET
LAKE ELSINORE CA 92530 X
(Page
8901 9403 8331 9482 88 NICOLE DAILEY 0.74 5.30 2.82
15045 ZIEGLINDE DR
LAKE ELSINORE CA 92530-5138