[SAMPLE LETTER, SHOULD BE TYPED ON COMPANY LETTERHEAD]

STATEMENT

 

TO: U.S. DEPARTMENT OF STATE
      WASHINGTON PASSPORT AGENCY

I, the undersigned, bearer of passport # __________________________________________________________

issued on (date of issue)____________________________________ and passport # _____________________issued on intend to
travel             to       (countries) ____________________________________________________________________________________________ on
(date of departure)__________________________________________________________

However, frequent international business travel, the need to obtain required visas on short notice, and restrictive entry polices of some countries, it is impossible to complete routine trips utilizing one passport. Moreover, to change my itinerary in order to utilize one passport will cause undue hardship and inconvenience. An airline itinerary detailing immediate travel is attached

(delete if not applicable) I am therefore requesting extension of validity of my limited passport for a further two years.

Should either passport be lost of stolen, I will report the circumstances immediately to the Passport Agency, or, if abroad, to the nearest American Embassy or Consulate General.

I understand that both passports must be submitted for inspection or cancellation when I request any passport service in the future.

I hereby authorize a representative of TRAVEL DOCUMENT SYSTEMS, INC. To collect my passport and to discuss the status of my application with the
Passport Service staff.

 

Signature:________________________________________________________

Date:      ________________________________________________________

Attachment: Copy of travel itinerary.