| US Passport Visa | ||||
| 2600 S. Gessner, Suite 330 Houston, Texas 77063 | ||||
| Specializing in Rush Passports, Visas for all Countries, and Certified Birth Certificates | ||||
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| 2ND LIMITED PASSPORT ORDER FORM | ||||
| Print this form, fill it out and send it to us with your information DO NOT PUT THIS FORM IN THE GOVERNMENT SEALED ENVELOPE |
Name(s) in passport/application(s):_____________________ ____________________________ Maiden Name: _____________________________________________________________________ |
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Phone:___________________________________E-Mail _______________________ |
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Have Federal Express deliver without a signature? (circle one) YES NO |
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Phone numbers: Work____________________ Home:_________________ Other:_______________ |
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Date of Birth(s):________________________ _________________________ |
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Date of Departure from the US:_______________ |
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| Credit Card Number: ______________________________ V- Code ( Required) |
US Passport Visa
The Passport & Visa Specialists Fees Passport $99.00 |
| Expires:_________________________ Signature_________________________ |
Return Delivery Fee:
Federal Express Weekday: $17.00 Federal Express Saturday $27.00 Airport to Airport $150.00 |
| We accept checks, money orders, cashiers checks,Visa, Mastercard, American Express and Discover. *PVS stands for Passport and Visa Specialists' processing fees. US Passport Visa, Passport and Visa Specialists or any of its agents our not responsible for mistakes or delays from passport offices, consulates, embassies travel agents, overnight courier services, or vital records departments. I understand that the passport office or above agencies can delay or deny passports, visas or birth certificates at their own discretion. |