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Childrens
Letter of Authorization
Attention
U.S. Passport Services,
I,
__________________________________, authorize Charsetta Reed and Jerry Eisom to process my application for U.S.
Passport and to pick-up the new passport.
_________________________
________________________ ____________
Applicant's
Signature
Social Security Number
Date of Birth
_______________
________________________
_____________________
Date
Work/Daytime Telephone
Home Telephone
Passport to be
shipped to:
| NAME(or
care of): |
_________________________________________________________________ |
| COMPANY: |
_________________________________________________________________ |
| ADDRESS: |
_________________________________________________________________ |
| CITY,STATE,ZIP |
_________________________________________________________________ |
| TELEPHONE: |
_________________________________________________________________ |
|
FED-EX ALL DOCUMENTS
TO THIS ADDRESS:
OVERNIGHT PASSPORT COURIER
ATTN: JERRY EISOM
187 DARTMOUTH STREET
BOSTON, MA 02116
Please call with your FED-EX air bill tracking numbers.
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