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EFTA01306399 | EFTA01306401 Scanned Document Collection Page 3 of 3 Innen You neeu It Fast 1961 Travisa Passport & Visa Service Letter of Authorization Pt 9 ?cog C al$'2..k• et I \leen , Date of Birth: Place of Birth: I AUTHORIZE TRAVISA PASSPORT & VISA SERVICE TO SUBMIT MY PASSPORT APPLICATION TO A U.S. PASSPORT AGENCY. AND TO ACCEPT DELIVERY OF THE PASSPORT ON MY BEHALF. Under the provolone of the Privacy Act of 1974 (Public Law 93-579.1 no information may be released from U.S. Government files without poor wntton consent of the individual in question consequently. an employee of the 11 5 • oort ' lane), cannot disc, s the details of your passport application with T•avna Panport I /isa vnmout you' nen ss,on Please ^moo•• one of me 7 ❑ , Pr sport. le -v to di 'us any rohlew • authorize Passport sew...anon w,th ...visa l-esvpOrt VI*. aervicv uch V ans. •th my I want the U.S. Passport Agency to contact me directly should a problem anse with my passport application which concerns mallets other than the date on which the passport will be ready for pick up (OrigOal Signature) 2/24/2020 SDNY_GM_00323945 EFTA_00196630 EFTA01306401
February 17, 2026 at 3:44 AM