U.S. Department of State
Passport Agency
I, _________________________________ hereby give my
authorization to BirthCertificatePassports.com and it's agents to act on my behalf
regarding the processing of my passport. I have given my consent allowing
BirthCertificatePassports.com to submit and collect my completed passport as well as
permission to discuss my application with a Passport Office Agent should it be
deemed necessary.
My date of birth is:______________________
I will be departing the United States
on _______________________.
I am requesting that my application be expedited, as I am required to obtain a
visa(s) to enter _________________________.
_____________________________________
Original signature of applicant
_____________________________________
Parents signature if applicant is under 16 yrs. Old
PLEASE NOTE:
WE MUST HAVE AN EXTRA COPY OF THIS LETTER AND A COPY OF YOUR PROOF
OF DEPARTURE ON THE OUTSIDE OF YOUR SEALED ENVELOPE
*Note to Applicant
1. This letter must bear the true and correct signature of the parent.
2. A husband may not sign on behalf of his wife, or vise versa.
3. In the event that it becomes necessary this letter also authorizes "Passport Services" to mail
passport back to our company ''.
4. is not responsible for delays in
processing due to incomplete applications, missing or incorrect proof
of US Citizenship, proof of identity, proof of travel, missing
photographs, incorrect passport execution fees. I understand that
delays in processing may occur due to the volume and workload at the
passport agency and they are not the responsibility of