USA Passport Office 
Dear Sir/Madam 
I, ____________________________________________, hereby authorize Travisa/IES/Worldwide Visa
 to submit my passport application and collect it when issued. 
The following visas are required prior to my departure: 
________________________________________________________________ 
Thank you for your prompt attention to my application 
Sincerely, 
____________________________________ 
Original Signatures of Applicant/Applicant's Child 
(faxed/photocopied signatures not accepted)