TDS

TRAVEL DOCUMENT SYSTEMS, INC.

Tel: 1-888-874-5100
415-773-2829
Fax: 415-773-2834

To: U.S. Department of State
      Passport Agency

I,________________________________________________________________
            (full name and birth date)
hereby authorize TRAVEL DOCUMENT SYSTEMS to pick up my passport and to discuss the status of my application with the Passport Services Staff.

My departure date from the United States is ______________________.

________________________________________
Signature of Applicant Only
(It is illegal for any person other than the applicant to sign this passport document. Original signature is required.)

________________________________________
Signature of parent if applicant is under age 18

Complete if Applicable:
I am requesting that my application for passport be expedited, as I will also be required to apply for visas for the following country/ies:_____________________________________________.

A copy of my itinerary or air tickets are enclosed as confirmation of urgent departure.

Travel Document Systems, Inc.
3 Embarcadero Center, Lobby Level Suite 2
San Francisco CA 94111
Voice: 1-888-874-5100....Local: 415-399-1515
Fax: 415-399-1001
email: sfo@traveldocs.com