Appendix A 

Identification Statement Worksheet

All Periodicals publications must contain an identification statement. It must appear in easy-to-read type in one of the locations listed below. Check the box that indicates the location of your identification statement:

• One of the first five pages of the issue (count the cover only if it is marked as page 1).
• One of the last three nonadvertising pages (bound publications only).
• Masthead on the editorial page if the location of the editorial page is shown on the first page of the publication.
• The first page of the table of contents.

Please check that each of these elements appears in the identification statement and provide an example:

• Publication Title
• International Standard Serial Number (ISSN) or USPS number if ISSN not assigned
• Issue Date (may be on cover)
• Statement of Frequency
• Issue Number (may be on cover)
• Subscription Price (optional)
• Name and Address of Known Office of Publication
• Periodicals Imprint “(Periodicals Postage Pending at ¼)”
• Change of Address Information

Issue dates and numbers may appear on the spine edge of perfect-bound publications.

Note: If you don’t have a correct identification statement in your publication at the time you file this application, attach a letter to your application that shows the corrected identification statement as it will appear in the next printed issue of the publication.

Sample Identification Statement (Pending Publication)

THE DAILY TIMES Issue 5 March 2001 (ISSN 7132-698X) is published daily except Sundays and holidays for $28 per year by Wright News Co.,
123 Maine Avenue, Washington, DC 20024-0001. Periodicals postage pending at Washington, DC, and additional mailing offices.
POSTMASTER: Send address changes to THE DAILY TIMES, PO Box 4, Boulder, CO 80302-0004.