Corporate Account/

Custom Designed Agreement

(See Instructions on Reverse)
1. Agreement Number 2. Sched. Pickup 3. First Shipment Date 4. Cancellation Date
X/G City Code Cust. No. Leg No. International a. (See No. 19f)
b. Reshipment 5. Change Date 6. Item Number of Changed Information
c. Drop Shipment

7a. From (Company name, address, apt./suite no., city, state, ZIP+4) 8a. 8b. Earliest Pickup 8c. Latest Pickup
USPS Pickup
Pickup Charge
8d. Pickup Office ZIP Code
Waived
9a. 9b. Latest Drop-Off Time

9c. Facility Name PO AMF

Customer Drop-Off

7b. Company Representative Name and Telephone Number

9d. ZIP+4

10a. To (Company name, address, apt./suite no., city, state, ZIP+4) 11a. 11b. Earliest Delivery 11c. Latest Delivery
USPS Delivery
Delivery Charge
11d. Delivery Office ZIP Code
Waived
12a. 12b. Earliest Claim Time

12c. Facility Name PO AMF

Customer Claim

10b. Company Representative Name and Telephone Number

12d. ZIP+4

Mon. Tues. Wed. Thur. Fri. Sat. Sun. 14. Describe Exception to Established Frequency (Holiday, etc.)
Mailed On:
13.
Mon. Tues. Wed. Thur. Fri. Sat. Sun.
Delivered On: 15. Describe Less-Than-Weekly Service

16. Mailing Frequency Code 17. Deliv. Freq. Code 18. Service Code

19a. 19b. PO Name 19d. Accounting Unit Telephone Number

Express Mail
Corporate Account
Established at: 19c. PO Address (City, state, ZIP+4) 19e. EMCA Chargeback Code

19f. Scheduled Pickup Volume 19g. Agency Control No. 19h. Agency Cost Code No.

USPS Use Only

20. USPS Comments 21. Routing Information
Depart Via Arrive
Place Time (Flight no., highway contract no., etc.) Place Time

22. Service Industry Code (SIC) 23. Marketing No.

24. Account Representative

25. Delivery Time Confirmed With Destination by (Signature)

PS Form 5637, January 1995 Call 1-800-222-1811 for tracking and pickup
 Instructions

GENERAL 10a. Enter destination company name, mailing address, city, two-
letter state abbreviation, and ZIP+4.
This form serves as:
10b. Enter destination company representative name and telephone
(1) the agreement between the customer and the Postal Service; number.
(2) the implementing document for originating and destinating post 11a. Check box if USPS delivery. Check “Delivery Charge Waived”
offices authorizing the performance of the services described; only if shipments under this service leg are delivered at same
time and place, and on same frequency, as another service leg
(3) the record used by postal finance personnel to ensure that the
(with the same first six digits) that does not have this block
postage paid is correct; and
checked.
(4) an input document for a computer-based information system.
11b. Enter earliest time for pickup. Use 24-hour clock.
Complete the form carefully.
11c. Enter latest time for pickup. Use 24-hour clock.
11d. Enter 5-digit ZIP Code of office that will deliver shipment.
SPECIFIC
12a. Check box if customer will claim at post office.
1. Enter “X” in first block if an Express Mail Corporate Account 12b. Enter latest claim time. Use 24-hour clock.
(EMCA) customer; enter “G” if a federal government customer;
12c. Enter post office facility name and check appropriate box.
leave blank if neither applies.
12d. Enter post office facility ZIP+4.
If agreement is international, enter correct country code in
capital letters in last block; otherwise, leave blank. 13. Enter “X” in appropriate boxes. Do not use this block if
shipments are less frequent than once a week.
See Handbook DM-201, Express Mail Service, for instructions
on assigning agreement and account numbers. 14. Explain specifically and in enough detail so that receiving office
can understand exceptions. For international agreements, give
2a. Check box for a Scheduled Pickup Service agreement.
dates of holidays.
2b. Check box for a Reshipment agreement.
15. Explain specifically and in enough detail so that receiving office
2c. Check box for a Drop Shipment agreement. can understand exceptions. For international agreements, give
dates of holidays.
3. Check box if appropriate and enter date. (Always show month,
day, and year, in that order; use numerics; use two digits for 16. Enter mailing frequency code.
each. Example: enter an effective date of January 15, 1995,
17. Enter delivery frequency code.
as “01/15/95.”)
18. Enter two-digit service code.
4. Check box if appropriate and enter date (see instruction 3 for
date format). 19a. Complete items 19b through 19f if EMCA is indicated by an “X”
in first block of item 1. Also complete items 19g and 19h if a
5. Check box if change of information and enter effective date.
federal government customer.
6. Enter item number(s) with new information.
19b. Enter post office name where EMCA was established.
7a. Enter sending company name, mailing address, city, two-letter
19c. Enter post office address.
state abbreviation, and ZIP+4.
19d. Enter accounting unit telephone number.
7b. Enter sending company representative name and telephone
number. 19e. Enter EMCA chargeback code.
8a. Check box if USPS pickup. Check “Pickup Charge Waived” 19f. Enter scheduled pickup volume.
only if shipments under this service leg are picked up at same
19g. Enter agency control number (federal government only).
time and place, and on same frequency, as another service leg
(with the same first six digits) that does not have this block 19h. Enter agency cost code number (federal government only).
checked.
20. Enter USPS comments only.
8b. Enter earliest time for pickup. Use 24-hour clock (e.g., enter
21. Use 24-hour clock for times. Abbreviate places (“JFK,” “PO,”
“1300” rather than “1 p.m.”).
“SCF,” etc.). Show transportation in “via” column (“AA391,” “SR
8c. Enter latest time for pickup. Use 24-hour clock. 1560,” “MVS,” etc.). List prime flight trip first. If a back-up flight
is required, skip a line, then record. Do not include this
8d. Enter 5-digit ZIP Code of office that will pick up shipment.
information on customer copies of this form.
9a. Check box if customer will drop off at post office.
22. Enter service industry code (SIC).
9b. Enter latest drop-off time. Use 24-hour clock (e.g., enter “1300”
23. Enter marketing number.
rather than “1 p.m.”).
24. Enter account representative name.
9c. Enter post office facility name and check appropriate box.
25. Signature of employee confirming delivery time with destination.
9d. Enter post office facility ZIP+4.

PS Form 5637, January 1995 (Reverse)