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, Registers has a moderate Form Complexity Index of 61/100 — Instafill’s AI completes it in under a minute.
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Completed sample of PS Form 3854, Registers, showing a dispatch record of registered mail from a local post office.

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
Completed sample of PS Form 3854, Registers, showing a dispatch record of registered mail from a local post office.