Letter of Authority for Passport Pickup

I, ________________________authorize _________________________to pick up my and/or

my family member’s passport/documents. This authorization allows the bearer to pick up the
passports of my following family members:

Name: __________________ Passport Number_____________ (Relationship) ______________

Name: __________________ Passport Number_____________ (Relationship) ______________

Name: __________________ Passport Number_____________ (Relationship) ______________

Name: __________________ Passport Number_____________ (Relationship) ______________

Name: __________________ Passport Number_____________ (Relationship) ______________

Name: __________________ Passport Number_____________ (Relationship) ______________

Name: __________________ Passport Number_____________ (Relationship) ______________

Name: __________________ Passport Number_____________ (Relationship) ______________

Name: __________________ Passport Number_____________ (Relationship) ______________

Name: __________________ Passport Number_____________ (Relationship) ______________

Required Attachments:
• Attach a copy of applicant’s National ID.
• Attach a copy of the National ID for all applicants 18 years and over.
• Attach a copy of the birth certificate of any children under 18 years of age listed here.

Signatures (All applicants over 18 must sign this form AND attach a copy of their National ID)

Name: ___________________ Signature: _______________________ Date:______________

Name: ___________________ Signature: _______________________ Date:______________

Name: ___________________ Signature: _______________________ Date:______________

Name: ___________________ Signature: _______________________ Date:______________

Name: ___________________ Signature: _______________________ Date:______________

Name: ___________________ Signature: _______________________ Date:______________