| X | Your Passenger I.D. Number, if known:
PLEASE COPY THE FOLLOWING INFORMATION FROM YOUR PASSPORT:
Your Full Name, as listed in your passport:
Passport Number:
Birthdate (month, date & year):
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Birthplace (US state or foreign country):
Citizenship:
Occupation:
Passport Agency, as listed in your passport:
Date of Issue (month, date & year):
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Expiration Date (month, date & year): NOTE: Your passport must be valid for at least 6 months after your return date.
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