Credit Card Form Uk (Credit Card Balance Sheet)

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Credit Card Form
Payable only to the British Embassy Government Account.
Please charge the following account for the applicable passport fees:
Mastercard
Visa
:
Card Number
Expiry Date:
Cardholder’s Name:
Cardholder’s Address: PLEASE ONLY COMPLETE IF THIS IS DIFFERENT TO THE ADDRESS YOU HAVE LISTED ON YOUR
PASSPORT APPLICATION FORM
Street
City:
State:
Zip:
Area Code:
Tel (wk): _________________
Tel (hm): ___________________
Email address:
_____________________________________________________
Signature:
The actual passport fees at the time of issuance may fluctuate from the published fee. Your signature on this form authorises us to
charge your account for the actual fee, provided that it is not more than $30 above the currently published fee.
You will not receive a receipt showing the actual fee, unless you have supporting documents to be returned, or if you specifically ask for
one. You may request a receipt by ticking the following box.
Request Receipt
In the event that your passport application is rejected due to insufficient supporting evidence, your documentation will normally be returned via
USPS for US residents and DHL for residents in Canada, Caribbean, Central and South America. An additional charge will be made to your
credit card to cover postage by USPS/DHL on resubmission of your application.
The postage fees are shown below.
Postage Fees:
Jamaica
$38.00 per person
Venezuela
$54.73 per person
All other countries
$33.00 per person
th
As of September 29
2011 British Passports are printed in the United Kingdom. Your new passport will be
sent to you from the UK. Your supporting documentation, supplied with your application, will be sent to
you from Washington DC.

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