Travelers name:_____________________________________________________________

Billing Address:______________________________________________________________

________________________________________________________________________________

_______________________________________________________________________________

Contact name and Phone#:________________________________________________________

Shipping Address(if different from billing address)________________________________
_______________________________________________________________________________
______________________________________________________________________________

Return service requested: Fed ex, UPS, ______________
Due to shipping problems with DHL we will not ship DHL unless specifically requested by the applicant.
Applicants who choose to ship DHL do so at their own risk, Expert Visa will accept no responsibility for packages shipped via DHL

Fed ex/UPS account number:_______________________________________________
If you do not have a Fed Ex/UPS account number we will bill the return shipping to the applicants credit card. If applicants wish to have their documentation shipped DHL or USPS they will need to provide their account# or air bill/envelope for return shipping.

Signature required ____ No Signature Required ____(If nothing is checked we will ship the package signature required)

Departure Date from the U.S.:______________ Need Back Date:_______________

Processing required(Country for which visa is requested or Passport process requested)

First Time Passport _____ Application For Passport By Mail (renew)_____Additional Pages_____Passport Reissue_____Lost or Stolen Passport_____
Passport Card_____
Date of Birth _____________(needed for first time passport/ lost or stolen applications, without the date of birth we cannot track the status of your first time/ lost or stolen passport application)

Country for which Visa Required (number of entries, legnth of visa etc.)__________________________________

Method of Payment: Credit card, check, money order

Credit card Number:____________________________________________________________

expiration date:________ Name on Card:_______________________________________

security number:__________

INFORMATION REGARDING SHIPMENTS: Expert Visa Services, Inc. is not responsible for package shipments once the parcels are provided to shipping companies such as Fed ex, UPS, DHL, and including other methods of shipment. This includes delays resulting from inclement weather or internal problems experienced by these package carrier services.