**Self-Certification Statement and Application\
*for*\
United States Postal Service^®^ *FASTforward*^^ Licensee**

Please Print

  ---------------- ------- ------- ------- ------- ------- ------- -------- ------- ------- ------- -------- --- --------------- ------
  Company Name:                                                                                                                  

  Company Address:                                                                                                               

  City:                                                            State:                           ZIP+4:                       

  North American                                                                                                                 
  Industry                                                                                                                       
  Classification                                                                                                                 
  System (NAICS):                                                                                                                

  Telephone No.:                                                            Fax                                                  
                                                                            No.:                                                 

  Parent Company                                                                                                                 
  (if applicable):                                                                                                               

  Contact Name:                                                                                                                  

  E-mail Address:                                                                                                                

  Vendor Company                                                                                                                 
  Name:                                                                                                                          
  ---------------- ------- ------- ------- ------- ------- ------- -------- ------- ------- ------- -------- --- --------------- ------

**TERMS AND CONDITIONS OF APPLICATION FOR LICENSE**

1.  The United States Postal Service *FASTforward* technology, as stated
    in the License Agreement, may only be used to prepare mail for the
    purpose of acceptance and delivery by the USPS^®^ (United States
    Postal Service^®^) or to provide address information that will be
    used to correct addresses for the same purpose.

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```
1.  Prior to consideration for a *FASTforward* license, I, as a
    potential Licensee, must demonstrate that the multiline optical
    character reader(s) (MLOCR) to be *FASTforward* -enhanced will have
    obtained and will keep current a USPS MASS™ (Multiline Accuracy
    Support System) certification.

2.  Prior to consideration for a *FASTforward* license, I, as a
    potential Licensee, must demonstrate, in accordance with Section 6.1
    of the *Licensee Performance Requirements*, that I have obtained
    (purchased, leased, or created) an MLOCR system(s) that has been
    USPS-precertified as *FASTforward* capable.

3.  No *FASTforward* license will be granted to me prior to USPS
    acceptance testing and approval of my specific MLOCR platform at my
    site.

**I hereby affirm that I have read and fully understand the terms and
conditions listed above. I, my company, and/or firm agree to meet these
terms and conditions as a prerequisite to applying for or obtaining a
USPS *FASTforward* License Agreement.**

  ------------ ------- -------- ----------------------- ------- ----------------------
  Name (please                                                  
  print):                                                       

  Title:                                                        

  Signature:                                            Date:        
  ------------ ------- -------- ----------------------- ------- ----------------------

***FASTforward*^^**

**Multiline Optical Character Reader (MLOCR)**

**Potential Licensee Survey**

<table style="width:100%;">
<colgroup>
<col style="width: 13%" />
<col style="width: 1%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 0%" />
<col style="width: 16%" />
<col style="width: 0%" />
<col style="width: 6%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 7%" />
<col style="width: 5%" />
<col style="width: 6%" />
<col style="width: 0%" />
<col style="width: 7%" />
<col style="width: 16%" />
<col style="width: 7%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="17"><blockquote>
<p><mark><strong>LICENSING CONTACT:</strong> (Primary contacts for
licensing issues)</mark></p>
</blockquote></td>
</tr>
<tr class="even">
<td colspan="4"><blockquote>
<p>Company Name:</p>
</blockquote></td>
<td colspan="12">     </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="3"><blockquote>
<p>Address:</p>
</blockquote></td>
<td colspan="13">     </td>
<td></td>
</tr>
<tr class="even">
<td><blockquote>
<p>City:</p>
</blockquote></td>
<td colspan="6">     </td>
<td colspan="2">State:</td>
<td colspan="5">     </td>
<td>ZIP+4:</td>
<td>     -     </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="4">(     )     -     </td>
<td colspan="2">Ext:</td>
<td colspan="4">     </td>
<td>FAX:</td>
<td colspan="3">(     )     -     </td>
<td></td>
</tr>
<tr class="even">
<td colspan="4"><blockquote>
<p>Primary Contact:</p>
</blockquote></td>
<td colspan="12">     </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="8">(     )     -     </td>
<td>Email:</td>
<td colspan="5">     </td>
<td></td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>Alternate Contact 1:</p>
</blockquote></td>
<td colspan="11">     </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="8">(     )     -     </td>
<td>Email:</td>
<td colspan="5">     </td>
<td></td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>Alternate Contact 2:</p>
</blockquote></td>
<td colspan="11">     </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="8">(     )     -     </td>
<td>Email:</td>
<td colspan="5">     </td>
<td></td>
</tr>
</tbody>
</table>

<table>
<colgroup>
<col style="width: 14%" />
<col style="width: 1%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 0%" />
<col style="width: 17%" />
<col style="width: 0%" />
<col style="width: 6%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 7%" />
<col style="width: 5%" />
<col style="width: 6%" />
<col style="width: 0%" />
<col style="width: 8%" />
<col style="width: 16%" />
<col style="width: 1%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="16"><blockquote>
<p><mark><strong>SITE CONTACT:</strong> (Location of
<em>FASTforward</em> system)</mark></p>
<p><mark></mark></p>
</blockquote></td>
<td><mark></mark></td>
</tr>
<tr class="even">
<td colspan="4"><blockquote>
<p>Company Name:</p>
</blockquote></td>
<td colspan="13">     </td>
</tr>
<tr class="odd">
<td colspan="3"><blockquote>
<p>Address:</p>
</blockquote></td>
<td colspan="14">     </td>
</tr>
<tr class="even">
<td><blockquote>
<p>City:</p>
</blockquote></td>
<td colspan="6">     </td>
<td colspan="2">State:</td>
<td colspan="5">     </td>
<td>ZIP+4:</td>
<td colspan="2">     -     </td>
</tr>
<tr class="odd">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="4">(     )     -     </td>
<td colspan="2">Ext:</td>
<td colspan="4">     </td>
<td>FAX:</td>
<td colspan="4">(     )     -     </td>
</tr>
<tr class="even">
<td colspan="4"><blockquote>
<p>Primary Contact:</p>
</blockquote></td>
<td colspan="13">     </td>
</tr>
<tr class="odd">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="8">(     )     -     </td>
<td>Email:</td>
<td colspan="6">     </td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>Alternate Contact 1:</p>
</blockquote></td>
<td colspan="12">     </td>
</tr>
<tr class="odd">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="8">(     )     -     </td>
<td>Email:</td>
<td colspan="6">     </td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>Alternate Contact 2:</p>
</blockquote></td>
<td colspan="12">     </td>
</tr>
<tr class="odd">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="8">(     )     -     </td>
<td>Email:</td>
<td colspan="6">     </td>
</tr>
</tbody>
</table>

<table>
<colgroup>
<col style="width: 14%" />
<col style="width: 1%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 0%" />
<col style="width: 17%" />
<col style="width: 0%" />
<col style="width: 6%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 7%" />
<col style="width: 5%" />
<col style="width: 6%" />
<col style="width: 0%" />
<col style="width: 8%" />
<col style="width: 16%" />
<col style="width: 1%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="16"><blockquote>
<p><mark><strong>MEDIA CONTACT:</strong> (Primary contacts for CD
fulfillment)</mark></p>
<p><mark></mark></p>
</blockquote></td>
<td></td>
</tr>
<tr class="even">
<td colspan="4"><blockquote>
<p>Company Name:</p>
</blockquote></td>
<td colspan="13">     </td>
</tr>
<tr class="odd">
<td colspan="3"><blockquote>
<p>Address:</p>
</blockquote></td>
<td colspan="14">     </td>
</tr>
<tr class="even">
<td><blockquote>
<p>City:</p>
</blockquote></td>
<td colspan="6">     </td>
<td colspan="2">State:</td>
<td colspan="5">     </td>
<td>ZIP+4:</td>
<td colspan="2">     -     </td>
</tr>
<tr class="odd">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="4">(     )     -     </td>
<td colspan="2">Ext:</td>
<td colspan="4">     </td>
<td>FAX:</td>
<td colspan="4">(     )     -     </td>
</tr>
<tr class="even">
<td colspan="4"><blockquote>
<p>Primary Contact:</p>
</blockquote></td>
<td colspan="13">     </td>
</tr>
<tr class="odd">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="8">(     )     -     </td>
<td>Email:</td>
<td colspan="6">     </td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>Alternate Contact 1:</p>
</blockquote></td>
<td colspan="12">     </td>
</tr>
<tr class="odd">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="8">(     )     -     </td>
<td>Email:</td>
<td colspan="6">     </td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>Alternate Contact 2:</p>
</blockquote></td>
<td colspan="12">     </td>
</tr>
<tr class="odd">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="8">(     )     -     </td>
<td>Email:</td>
<td colspan="6">     </td>
</tr>
</tbody>
</table>

<table style="width:100%;">
<colgroup>
<col style="width: 14%" />
<col style="width: 1%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 0%" />
<col style="width: 0%" />
<col style="width: 4%" />
<col style="width: 11%" />
<col style="width: 0%" />
<col style="width: 0%" />
<col style="width: 0%" />
<col style="width: 6%" />
<col style="width: 0%" />
<col style="width: 0%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 0%" />
<col style="width: 7%" />
<col style="width: 0%" />
<col style="width: 5%" />
<col style="width: 0%" />
<col style="width: 6%" />
<col style="width: 0%" />
<col style="width: 0%" />
<col style="width: 0%" />
<col style="width: 7%" />
<col style="width: 0%" />
<col style="width: 16%" />
<col style="width: 0%" />
<col style="width: 3%" />
</colgroup>
<tbody>
<tr class="odd">
<td
colspan="28"><p><strong><em>FASTforward</em><sup></sup></strong></p>
<p><strong>Multiline Optical Character Reader (MLOCR)</strong></p>
<p><strong>Potential Licensee Survey</strong></p>
<blockquote>
<p><mark></mark></p>
<p><mark><strong>TECHNICAL CONTACT:</strong> (Primary contacts for
technical issues)</mark></p>
<p><mark></mark></p>
</blockquote></td>
<td colspan="2"><mark></mark></td>
</tr>
<tr class="even">
<td colspan="4"><blockquote>
<p>Company Name:</p>
</blockquote></td>
<td colspan="24">     </td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3"><blockquote>
<p>Address:</p>
</blockquote></td>
<td colspan="25">     </td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td><blockquote>
<p>City:</p>
</blockquote></td>
<td colspan="9">     </td>
<td colspan="4">State:</td>
<td colspan="10">     </td>
<td colspan="2">ZIP+4:</td>
<td colspan="2">     -     </td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="6">(     )     -     </td>
<td colspan="4">Ext:</td>
<td colspan="8">     </td>
<td colspan="2">FAX:</td>
<td colspan="6">(     )     -     </td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="4"><blockquote>
<p>Primary Contact:</p>
</blockquote></td>
<td colspan="24">     </td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="14">(     )     -     </td>
<td colspan="2">Email:</td>
<td colspan="10">     </td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>Alternate Contact 1:</p>
</blockquote></td>
<td colspan="23">     </td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="14">(     )     -     </td>
<td colspan="2">Email:</td>
<td colspan="10">     </td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="5"><blockquote>
<p>Alternate Contact 2:</p>
</blockquote></td>
<td colspan="23">     </td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="14">(     )     -     </td>
<td colspan="2">Email:</td>
<td colspan="10">     </td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="29"><blockquote>
<p><mark></mark></p>
<p><mark><strong>MARKETING CONTACT:</strong> (Information to be posted
on USPS RIBBS Website YES NO)</mark></p>
<p><mark></mark></p>
</blockquote></td>
<td><mark></mark></td>
</tr>
<tr class="odd">
<td colspan="4"><blockquote>
<p>Company Name:</p>
</blockquote></td>
<td colspan="25">     </td>
<td></td>
</tr>
<tr class="even">
<td colspan="3"><blockquote>
<p>Address:</p>
</blockquote></td>
<td colspan="26">     </td>
<td></td>
</tr>
<tr class="odd">
<td><blockquote>
<p>City:</p>
</blockquote></td>
<td colspan="10">     </td>
<td colspan="4">State:</td>
<td colspan="10">     </td>
<td colspan="2">ZIP+4:</td>
<td colspan="2">     -     </td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="7">(     )     -     </td>
<td colspan="4">Ext:</td>
<td colspan="8">     </td>
<td colspan="2">FAX:</td>
<td colspan="6">(     )     -     </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="4"><blockquote>
<p>Primary Contact:</p>
</blockquote></td>
<td colspan="25">     </td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="15">(     )     -     </td>
<td colspan="2">Email:</td>
<td colspan="10">     </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="5"><blockquote>
<p>Alternate Contact 1:</p>
</blockquote></td>
<td colspan="24">     </td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="15">(     )     -     </td>
<td colspan="2">Email:</td>
<td colspan="10">     </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="5"><blockquote>
<p>Alternate Contact 2:</p>
</blockquote></td>
<td colspan="24">     </td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="15">(     )     -     </td>
<td colspan="2">Email:</td>
<td colspan="10">     </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="6"><blockquote>
<p>Company Web site:</p>
</blockquote></td>
<td colspan="23">     </td>
<td></td>
</tr>
<tr class="even">
<td colspan="7"><blockquote>
<p>Customer Service Email:</p>
</blockquote></td>
<td colspan="22">     </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="7"><blockquote>
<p>Customer Service Phone:</p>
</blockquote></td>
<td colspan="22">     </td>
<td></td>
</tr>
<tr class="even">
<td colspan="30"><blockquote>
<p><mark><strong>BILLING CONTACT:</strong> (Primary contacts for billing
issues)</mark></p>
</blockquote></td>
</tr>
</tbody>
</table>

<table>
<colgroup>
<col style="width: 14%" />
<col style="width: 1%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 0%" />
<col style="width: 17%" />
<col style="width: 0%" />
<col style="width: 6%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 7%" />
<col style="width: 5%" />
<col style="width: 6%" />
<col style="width: 0%" />
<col style="width: 8%" />
<col style="width: 17%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="4"><blockquote>
<p>Company Name:</p>
</blockquote></td>
<td colspan="12">     </td>
</tr>
<tr class="even">
<td colspan="3"><blockquote>
<p>Address:</p>
</blockquote></td>
<td colspan="13">     </td>
</tr>
<tr class="odd">
<td><blockquote>
<p>City:</p>
</blockquote></td>
<td colspan="6">     </td>
<td colspan="2">State:</td>
<td colspan="5">     </td>
<td>ZIP+4:</td>
<td>     -     </td>
</tr>
<tr class="even">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="4">(     )     -     </td>
<td colspan="2">Ext:</td>
<td colspan="4">     </td>
<td>FAX:</td>
<td colspan="3">(     )     -     </td>
</tr>
<tr class="odd">
<td colspan="4"><blockquote>
<p>Primary Contact:</p>
</blockquote></td>
<td colspan="12">     </td>
</tr>
<tr class="even">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="8">(     )     -     </td>
<td>Email:</td>
<td colspan="5">     </td>
</tr>
<tr class="odd">
<td colspan="5"><blockquote>
<p>Alternate Contact 1:</p>
</blockquote></td>
<td colspan="11">     </td>
</tr>
<tr class="even">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="8">(     )     -     </td>
<td>Email:</td>
<td colspan="5">     </td>
</tr>
<tr class="odd">
<td colspan="5"><blockquote>
<p>Alternate Contact 2:</p>
</blockquote></td>
<td colspan="11">     </td>
</tr>
<tr class="even">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="8">(     )     -     </td>
<td>Email:</td>
<td colspan="5">     </td>
</tr>
</tbody>
</table>

***FASTforward*^^**

**Multiline Optical Character Reader (MLOCR)**

**Potential Licensee Survey**

+-----------------------------------------------------------------------+
| > **[POST OFFICE USED PRIMARILY FOR DEPOSTING MAIL:]{.mark}**         |
+-----------------------------------------------------------------------+

<table>
<colgroup>
<col style="width: 15%" />
<col style="width: 1%" />
<col style="width: 1%" />
<col style="width: 25%" />
<col style="width: 0%" />
<col style="width: 6%" />
<col style="width: 0%" />
<col style="width: 15%" />
<col style="width: 6%" />
<col style="width: 0%" />
<col style="width: 8%" />
<col style="width: 17%" />
</colgroup>
<tbody>
<tr class="odd">
<td><blockquote>
<p>Name:</p>
</blockquote></td>
<td colspan="11">     </td>
</tr>
<tr class="even">
<td colspan="3"><blockquote>
<p>Address:</p>
</blockquote></td>
<td colspan="9">     </td>
</tr>
<tr class="odd">
<td><blockquote>
<p>City:</p>
</blockquote></td>
<td colspan="4">     </td>
<td colspan="2">State:</td>
<td colspan="3">     </td>
<td>ZIP+4:</td>
<td>     -     </td>
</tr>
<tr class="even">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="2">(     )     -     </td>
<td colspan="2">Ext:</td>
<td colspan="2">     </td>
<td>FAX:</td>
<td colspan="3">(     )     -     </td>
</tr>
</tbody>
</table>

+-----------------------------------------------------------------------+
| > **[MLOCR MACHINE OPERATOR CONTACT:]{.mark}**                        |
+-----------------------------------------------------------------------+

<table>
<colgroup>
<col style="width: 15%" />
<col style="width: 1%" />
<col style="width: 1%" />
<col style="width: 25%" />
<col style="width: 0%" />
<col style="width: 6%" />
<col style="width: 0%" />
<col style="width: 15%" />
<col style="width: 6%" />
<col style="width: 0%" />
<col style="width: 8%" />
<col style="width: 17%" />
</colgroup>
<tbody>
<tr class="odd">
<td><blockquote>
<p>Name:</p>
</blockquote></td>
<td colspan="11">     </td>
</tr>
<tr class="even">
<td colspan="3"><blockquote>
<p>Address:</p>
</blockquote></td>
<td colspan="9">     </td>
</tr>
<tr class="odd">
<td><blockquote>
<p>City:</p>
</blockquote></td>
<td colspan="4">     </td>
<td colspan="2">State:</td>
<td colspan="3">     </td>
<td>ZIP+4:</td>
<td>     -     </td>
</tr>
<tr class="even">
<td colspan="2"><blockquote>
<p>Phone:</p>
</blockquote></td>
<td colspan="2">(     )     -     </td>
<td colspan="2">Ext:</td>
<td colspan="2">     </td>
<td>FAX:</td>
<td colspan="3">(     )     -     </td>
</tr>
</tbody>
</table>

What is your intended use of *FASTforward*:

-   Service Provider Only

-   In-House Processing Only

-   Both

  ---------- ------------------------------------------------------------
             

  ---------- ------------------------------------------------------------

  --------------------------------------------------- -------------------
  How many USPS *FASTforward* systems are you              
  requesting?                                         

  --------------------------------------------------- -------------------

***FASTforward*^^**

**Multiline Optical Character Reader (MLOCR)**

**Potential Licensee Information**

List *all* holidays observed by your facility, including those on which
the facility is closed.

  ------------------------------ -------- -------------------------------
                                               

                                               

                                               

                                               

                                               

                                               

                                               

                                               

                                               
  ------------------------------ -------- -------------------------------

Normal facility hours of operation:

  --------------------------------- -------------------------------------
  **Daily Work Schedule**           

  **Day**                           **Hours of Operation**

  Sunday                                 

  Monday                                 

  Tuesday                                

  Wednesday                              

  Thursday                               

  Friday                                 

  Saturday                               
  --------------------------------- -------------------------------------

Expected normal hours of *FASTforward* operation:

  --------------------------------- -------------------------------------
  **Schedule for *FASTforward*      
  processing**                      

  **Day**                           **Hours of Operation**

  Sunday                                 

  Monday                                 

  Tuesday                                

  Wednesday                              

  Thursday                               

  Friday                                 

  Saturday                               
  --------------------------------- -------------------------------------

\\0172FFD.DOC

***FASTforward*^^**

**Multiline Optical Character Reader (MLOCR)**

**Equipment Information**

*NOTE: This page may be copied for multiple systems. A [completed
form]{.underline} must be submitted for each system.*

  -----------------------------------------------------------------------
  Telephone number connected and dedicated [ONLY]{.underline} to the USPS
  *FASTforward* system at all times:\
  [(   )    -    ]{.underline}

  -----------------------------------------------------------------------

  ---------------- ------------------------------------------------------
  **MLOCR          
  Manufacturer     
  Information**    

  Contact Name          

  Vendor Name           

  Mailing Address       

  Telephone Number      
  ---------------- ------------------------------------------------------

  -------------------- --------------------------------------------------
  **Hardware           
  Information**        

  Model \#                  

  Serial \#                 

  Transport and Belt        
  Speed                

  Inkjet Printer and        
  Model \#             

  Optics (list all          
  cameras)             

                            

                            
  -------------------- --------------------------------------------------

  ---------------------------- ------------------------------------------
  **Software Information**     

  Character Recognition             
  Software and Version Number  

  CASS Certified™ Software and      
  Version Number               
  ---------------------------- ------------------------------------------

  ---------------------------------------------------------- ------------
  Number of MLOCR machines that will be attached to this          
  USPS *FASTforward* system:                                 

  ---------------------------------------------------------- ------------

\\0172FFD.DOC