CASS Form PS3553 Sample

CASS Summary report

A. Software

CASS A1

1. CASS Certified Company Name :
2. CASS Certified Software Name & Version :
3. Configuration :
4. Z4Change Certified Company Name :
5. Z4Change Certified Software Name & Version :
6. Configuration :
7. DirectDPV Certified Company Name :
8. DirectDPV Certified Software Name & Version :
9. Configuration :
10. eLOT Certified Company Name :
11. eLOT Certified Software Name & Version :
12. Configuration :

MASS A2

1. MASS Certified Company Name :
2. MASS Certified Software Name, Version & Model No. :
3. Configuration :
4. MLOCR Serial No. :

B. List

1. List Processor’s Name :
2. Date List Processed
3. Master File: 04/24/2018
4. Z4Change :
5. DirectDPV :
6. eLOT : 04/24/2018
7. CRIS : 04/24/2018
8. Date of Database Product Used
9. ZIP + 4 File :
10. Z4Change :
11. DirectDPV :
12. eLOT :
13. CRIS :
14. List Name or ID No. :
15. Number of Lists : 1
16. Total Records Submitted for Processing :

C. Output

1. 1. Total ZIP+4/DPV Confirmed :

Validation Period : 04/24/2018 – 10/21/2018

1. 1. Total Z4Change Processed :
   2. Total DirectDPV :

Validation Period : 04/24/2018 – 10/21/2018

1. 1. Total 5-Digit Coded :

Validation Period : 04/24/2018 – 04/24/2019

1. 1. Total CRRT Coded :

Validation Period : 04/24/2018 – 07/23/2018

1. 1. Total eLOT Coded :

Validation Period : 04/24/2018 – 07/23/2018
D. Mailer

I certify that the mailing submitted with this form has been coded (as indicated
above) using CASS Certified software meeting all of the requirements listed in
the DMM Section 708.

1. 1. 1. Signature :
      2. Date : 04/24/2018
      3. Name and Address of Mailer :

 

E. Qualitative Statistical Summary (QSS)

1. 1. High Rise Default :
   2. High Rise Exact :
   3. RR Default :
   4. RR Exact :
   5. LACSLink :
   6. EWS :
   7. SuiteLink :