Specializing in Rush Passports, Visas for all Countries, and Certified Birth Certificates. Promotion Code: default

ORDER FORM

Print this form, fill it out and send it to us with your information
DO NOT PUT THIS FORM IN THE GOVERNMENT SEALED ENVELOPE

Ship FED-EX only.
Do NOT use any other carrier.
Ship to:
BirthCertificatePassports.com
2020 Montrose Blvd Suite 400
Houston, Texas 77006
888-629-0087

IMPORTANT: Please fill out the following information and fax this sheet to (281) 416-9554. Also send this original copy with your passport information.

Please write in your
FED-EX TRACKING NUMBER here

_______________________________________

Name(s) in passport/application(s):_____________________ ____________________________

Maiden Name: _____________________________________________________________________

Shipping address and phone number
for Federal Express Delivery:

Address for Saturday Delivery: ( if needed )

__________________________

______________________________

___________________________

______________________________

Phone:____________________________________________E-Mail _____________________________

Have Federal Express deliver without a signature? (circle one) YES NO

Phone numbers: Work____________________ Home:_________________ Other:_______________

Date of Birth(s):________________________ _________________________

Date of Departure from the US:_______________

Payment Information ( please fill in)
US Goverment Fee	$_____________
BPVS Fee*	$ 99.00
Return Delivery Fee	$25.00 or $37.00
Total	$_____________

US Goverment Fees (per person)
New/Lost Passport $135.00 Adult (in sealed envelope) $120.00 Child
Renewal $135.00
Extra Pages $60.00
Name Change $60.00

BirthCertificatePassports.com processed my birth certificate and passport up front (no service fees needed above for BCP)ONLY US GOVERNMENT FEES PER PERSON.

Credit Card Number: ______________________________	BirthCertificatePassports.com Fees Passport $99.00
Expires:_________________________ Signature_________________________	Return Delivery Fee: Federal Express Weekday: $25.00 Federal Express Saturday $37.00 Airport to Airport $250-$400

We accept checks, money orders, cashiers checks, Visa, Mastercard, American Express and Discover.

*BirthCertificatePassports.com processing fees. BirthCertificatePassports.com or any of its agents our not responsible for mistakes or delays from passport offices, consulates, embassies travel agents, overnight courier services, or vital records departments. I understand that the passport office or above agencies can delay or deny passports, visas or birth certificates at their own disgression.

Promotion Code: default