Visas Intl - Passport Orderform

Please check the boxes that apply to your trip and fill in all of the blanks below. When you are done, please click the finish button and we will complete a payment authorization form for you to print out.
Please note that we do not store or track any credit card information. We cannot process any payments until we receive a completed and signed authorization along with your original documents. Please remember to fill in your credit card number by hand before you send your package to us.
Upon completion, this information will be uploaded into a Payment Authorization Form, which should be printed and Signed, before sending to us for processing.
Please Print, Sign and Send all necessary Steps from your checklist to:

ADAMS PASSPORTS & VISAS
3005 W. Victory Blvd.
Burbank, CA 91505

Please choose all that apply:

1. Number of ORDERS for a New Passport or a Passport Renewal, if any ($115)

2. Number of ORDERS for Additional Pages, if any ($60)


3. Shipping:
To Continental U.S.:
Regular shipping via Federal Express Economy Service (2nd Day):	$25.00
Priority Federal Express (next business morning):	$35.00

To Alaska, Hawaii, and Puerto Rico:
Regular shipping via Federal Express Economy Service (2nd Day):	$37.00
Priority Federal Express (next business morning):	$55.00

If you need NEXT DAY or SAME DAY emergency passport service, please call us at (800) 638-1517 for rush fees.

If you provide a valid email address, we will email you a confirmation of receipt, as well as your Fedex return tracking number upon shipping.

Personal Information

First Name

Last Name

Billing Address

(Street)

City

State Abbr.

Zip Code

Shipping Address as billling address?

Shipping Address

(Street)

City

State Abbr.

Zip Code

Email Address

Repeat Email Address

Travel Agent

(list your Travel Agency name)

Payment Options

Personal Check

Money Order

Credit Card

Type:

Master Card Visa American Express

Expiry :