When Deliverd Visa and Master Card CashOut
APPLICANT INFORMATION
Applicant Full Name :
Applicant Phone Number :
Date :
Applicant Signature :
LETTER OF AUTHORIZATION
Her Majesty's Passport Office
I authorize Ambassador Passport and Visa Services, Inc. to submit my Passport Application
on my behalf, and to pick-up my Passport by courier or mail.
I also authorize Her Majesty's Passport Office to disclose any requests for further documents
and/ or information that may arise in connection with my passport application, and I auth-
orize Ambassador Passport and Visa Services, Inc. to respond to such requests on my behalf.
DATE :
Acr99273273425612815077.pdf 1 1/17/18 5:24 PM
Acr992732734256128-15034.pdf 1 1/17/18 5:12 PM
Acr992732734256128-9528.pdf 1 1/17/18 5:44 PM
Statement of non-liability: Ambassador Passport and Visa Services, Inc. is not responsible for mistakes, delays, or decisions
by the U.S. Government, passport offices, consulates, embassies, travel agents, courier services, foreign governments, various
records departments, as well as uncontrollable events such as forcemajeurs and acts of God. I understand that the passport
office or visa office or any of the above agencies can delay or deny passports, visas or birth certificates. Ambassador
Passport and Visa Services, Inc. will not be held liable for any financial loss occurred by delay in the process. Regardless of
the result, Ambassador Passport and Visa Services can collect its fees, once the service has been conducted. By submitting
this application, you agree to these terms.
AMBASSADOR PASSPORT AND VISA SERVICES, INC.
2811 Wilshire Blvd., Suite 720, Santa Monica, CA 90403
Tel: (310) 828-7878 • Fax: (310) 828-7474
AmbassadorPassportandVisa.com • info@ambpv.com
Ambassador Passport and Visa Services, Inc.
When Deliverd Visa and Master Card CashOut
APPLICANT INFORMATION
Applicant Full Name :
Applicant Phone Number :
Date :
Applicant Signature :
LETTER OF AUTHORIZATION
Her Majesty's Passport Office
I authorize Ambassador Passport and Visa Services, Inc. to submit my Passport Application
on my behalf, and to pick-up my Passport by courier or mail.
I also authorize Her Majesty's Passport Office to disclose any requests for further documents
and/ or information that may arise in connection with my passport application, and I auth-
orize Ambassador Passport and Visa Services, Inc. to respond to such requests on my behalf.
DATE :
Acr99273273425612815077.pdf 1 1/17/18 5:24 PM
Acr992732734256128-15034.pdf 1 1/17/18 5:12 PM
AMBASSADOR PASSPORT AND VISA SERVICES, INC.
Ambassador Passport and Visa Services, Inc., 1400 16th Street Suite 400 Denver,
Colorado, 80202 • Tel: (720) 400-7255 • Fax: (720) 400-7260
www.ambassadorpvdenver.com • info@ambassadorpvdenver.com
Acr992732734256128-9528.pdf 1 1/17/18 5:44 PM
Statement of non-liability: Ambassador Passport and Visa Services, Inc. is not responsible for mistakes, delays, or decisions
by the U.S. Government, passport offices, consulates, embassies, travel agents, courier services, foreign governments, various
records departments, as well as uncontrollable events such as forcemajeurs and acts of God. I understand that the passport
office or visa office or any of the above agencies can delay or deny passports, visas or birth certificates. Ambassador
Passport and Visa Services, Inc. will not be held liable for any financial loss occurred by delay in the process. Regardless of
the result, Ambassador Passport and Visa Services can collect its fees, once the s ervice has been conducted. By submitting
this application, you agree to these terms.
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