I (Parent/Guardian)___________________________________authorize American Passport

Express to process the application for US Passport of (Child's name)_________________________________

Child's Date of Birth:______/______/______, to pickup their completed passport and to discuss

all matters with the Department of State pertaining to the processing of my passport application and issuance

of my passport.

 

Signed (Parent/Guardian):_____________________________ Today's Date:______/______/______

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