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PAPERWORK REDUCTION ACT STATEMENT

PAPERWORK REDUCTION ACT STATEMENT

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Name of Passport Agent, Passport Acceptance Agent or Notary Location DS-60 10-2020 Page 2 of 2 NOTARY SEAL (Number and Street, City, State, and Zip Code) (Passport Agency or City & State) 1. Passport Applicant's Current Name Printed Name of Affiant (The affiant is the person filling out this form) Signature of Affiant Affiant's Social Security ...

  Name, Agency

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