Revised Forms for Rural Route Mail Count

Effective July 2012, in order to comply with the July 3, 2012, Interest Arbitration decision between the United States Postal Service® and the National Rural Letter Carri­ers Association, the following forms have been revised:

n PS Form 4239, Rural Route Count of Mail (see page 12).

n PS Form 4241, Rural Delivery Statistics Report (see page 13).

n PS Form 4241-M, Rural Route Evaluation Worksheet (see page 14).

The revised PS Forms 4239, 4241, and 4241-M are available on the Postal Service™ PolicyNet website:

n Go to

n Under “Essential Links” in the left-hand column, click Forms.

n Click 40004999 in the left sidebar.

n Click the icon next to the desired form name.

(The direct URL is

Rural Route Count of MailRural Route Count of Mail form

Rural Delivery Statistics Report formRural Delivery Statistics Report

Rural Route Evaluation WorksheetRural Route Evaluation Worksheet