I _______________________________________ authorize Embassy Passport to submit my US Passport Application, to receive my completed passport, and to discuss any issues with Passport Services regarding the processing of my application.
Signed:_____________________________
Date of Birth:________/________/________
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American Passport Express LLC. acts only as an agent on behalf of the applicant. Please Refer to our "Legal Terms" which appear on our website www.americanpassport.com and which are incorporated by reference.