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Bucktown Visas & Passports, Inc.

We specialize in expedited Service!

 
 
 
 
 
 
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****NOTE: We are currently experiencing difficulties receiving our order forms.  Until our website host company corrects this problem, please print out your order form and ship it to us along with all of your other documents.  We are sorry for any incovenience, and we thank you for your patience.****


Passport Order Form
Please FedEx all documents to:
Bucktown Visas & Passports, 2048 N. Stave St., Chicago, IL 60647-4025

*Please fill out only the fields that pertain to your order. You can just leave anything else blank.






**
By law, all government fees are nonrefundable.**






First Name
Last Name
Date of Departure
Billing Address Line 1 - NOTE: Billing address must match credit card
Billing Address Line 2 - NOTE: Billing address must match credit card
City
State, Zip
Daytime Phone() -
E-mail Address
Email address, continued, if necessary
Ship to address (if different than billing address above) Line 1
Ship to address (if different than billing address above) Line 2
Credit Card (AMEX, Visa, MC, Money Order, Company Check)
Name on credit card
Credit Card Number
Credit Card Expiration Date
First-Time Passport Government Fees, which are nonrefundable by law - $211.36
Renewal/Name Change/Second Passport - $211.36
Lost/Stolen/Damaged Passport - 211.36
Child?s Passport - $181.36
Amount of Government Fees
Amount of Bucktown Expediting Fees
Amount of Bucktown Return Shipping
Your own Return Bill of Lading enclosed (type in yes if applicable)
Total Amount of Order
  1. The government fees listed above for a new passport, a child's passport, or a lost, stolen, or damaged passport can be paid by personal check or money order, payable to "Department of State:" You will be giving this payment to the acceptance agent that you must go to, so that he/she can enclose it in your sealed envelope that you'll be shipping to us.  **By law, all government fees are nonrefundable.**
  2. The separate government execution fee of $35.00 that is charged for a new passport, a child's passport, or a lost, stolen, or damaged passport should already have been collected by your acceptance agent (local post office, county clerk's office) where you made your personal appearance. The acceptance agent keeps this $35.00. It does not go into your sealed envelope.
  3. For your convenience, for a passport renewal or name change, or for extra visa pages added to your passport, there are two ways to pay: 1) You can send us a personal check or money order for the proper amount of the government fee listed above, payable to "Department of State." 2) You can pay the full amount of your government fees and your Bucktown Visas & Passports expediting and return shipping fees with a company check or money order, payable to Bucktown Visas & Passports, Inc., or by credit card in just one simple payment.  We're sorry, Bucktown Visas & Passports, Inc. cannot accept personal checks.
  4. NOTE: The expediting and return shipping fees that go to Bucktown Visas & Passports, Inc. are in addition to your government fee and government execution fee, which are listed above.
  5. If you do not feel secure in filling out your credit card information, you may fill out this order form partially online, if you wish, and then print it out in order to hand print, legibly, and in ink, your credit card information, if paying with a credit card. Please enclose a copy of this order form with all of your other shipped documents, so that we do receive your credit card information.
  6. After you print this out, if you would like us to get a head start on your documents, click on the "Send" button, and this order form will go right to Bucktown Visas & Passports, Inc., (with everything filled in except your credit card information, if you chose not to fill that part in. We'll receive that with the copy of the order form you ship with your documents.) We can then get started on your documents because we will know before the documents actually arrive whether we will be doing a passport renewal with 3-day business service or a new passport with 48-hour service, etc.  (Note: If you click on the "Send" button before you print out the order form, your information will still go directly to us, however, you will have to type in all of your information again because the form will then go back to being blank.  So please print the order form first.)

Thanks for your business. We truly appreciate it!


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