I do not hold any passport or other form of travel

Info iconThis preview shows page 1. Sign up to view the full content.

View Full Document Right Arrow Icon
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: , state or sovereignty other than the United States. I do not hold any passport or other form of travel document issued to me by any foreign state or sovereign, except for the United States. DECLARATION: I declare that the statements made in this application are true and complete to the best of my knowledge and belief, that the attached photographs are a true likeness of me. Signature of Applicant: SIGN INSIDE THIS BOX Month Day Year Month Day Year 2”X2” PHOTO Subscribed and sworn to (affirmed) before me GLUE HERE ________________________________________________ AUTHORIZED OATH – ADMINISTERING OFFICIAL Clerk of Court Passport Agent Notary Public Palau Consular Serv.; Location/Title: DO NOT WRITE BELOW THIS SPACE FOR PASSPORT SERVICES USE ONLY SEAL DO NOT WRITE BELOW THIS Applicants evidence of citizenship Birth Certificate Filed/Issued: Passport Bearer’s Name: Report of Birth: Marriage Certificate Court Decree: Name Change Naturalization Other: Seen & Returned: BC P ROB MC Attached: BC P ROB MC CD CD OTH: OTH: APPLICATION APPROVAL FOR PASSPORT OFFICE USE ONLY [ ]- REGULAR [ ] - OFFICIAL [ ] - DIPLOMATIC [ ] - EXTENSION [ ] - AMENDMENT [ ] - NEW PASSPORT PASSPORT NUMBER:_________________________ ISSUANCE DATE:_________...
View Full Document

{[ snackBarMessage ]}

Ask a homework question - tutors are online