Just-In Document Service, Inc.
5 West Main Street, Suite 201
Elmsford, NY 10523
Phone: (914) 592 - 2760 Fax: (914) 592 - 2987
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RELEASE FORM TO PASSPORT SERVICES
Date: To: Passport Services-US Department of State 50 West Washington Street Norwalk, CT I authorize Just-In Document Service, Inc./New England Visa Service representatives (914-592-2760) to submit and pickup my child's application on my behalf for a US Passport. They have my full permission to handle all my passport needs and answer any questions that will help expedite this request. Signature: _________________________________ Relationship: Child's Name: Child's Date of Birth:
Date:
To: Passport Services-US Department of State
50 West Washington Street
Norwalk, CT
I authorize Just-In Document Service, Inc./New England Visa Service representatives (914-592-2760) to submit and pickup my child's application on my behalf for a US Passport. They have my full permission to handle all my passport needs and answer any questions that will help expedite this request.
Signature: _________________________________
Relationship:
Child's Name:
Child's Date of Birth: