PS Form 3854, Registers Completed Form Examples and Samples
Explore clear, filled-out examples and samples of PS Form 3854, Registers. Our detailed guides show you how to correctly complete the USPS Registered Mail Dispatch Log, making the process simple and error-free. Perfect for postal employees looking for a reliable template.
PS Form 3854 Example: Post Office Registered Mail Dispatch Log
How this form was filled:
This PS Form 3854 sample illustrates a daily dispatch of registered mail from the 'Anytown Post Office' to the 'Metro P&DC'. It correctly fills out the bill number, dispatch date, a list of registered article numbers with their destination ZIP codes, total articles, and includes the signatures of both the dispatching and witnessing clerks.
Information used to fill out the document:
- Dispatching Post Office: Anytown Post Office
- Station or Branch: Main Street Station
- Bill Number: 2026-1234
- Date of Dispatch: May 12, 2026
- Time of Dispatch: 17:30
- Receiving Office: Metro P&DC
- Dispatching Clerk: Jane Smith
- Witnessing Clerk: John Davis
- Registered Article #1: RE123456789US (To: 90210)
- Registered Article #2: RE987654321US (To: 10001)
- Registered Article #3: RE555444333US (To: 60607)
- Total Registered Articles: 3
What this filled form sample shows:
- Accurate logging of dispatching and receiving post office information.
- Correctly formatted Bill Number and Date of Dispatch.
- Detailed list of individual Registered Article numbers and their destination ZIP codes.
- Proper completion of signature and verification fields by dispatching and witnessing employees.
Form specifications and details:
| Form Name: | PS Form 3854 |
| Form Title: | Manifold Registry Dispatch Book |
| Use Case: | Daily dispatch of registered mail from a local post office to a processing and distribution center. |
| Created: | February 04, 2026 02:17 AM |