REQUEST FOR AUTHORIZATION NOT TO APPEAR IN PERSON


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I, the undersigned,

Name
Passport #
Passport (Country)
Address 1
Address 2
City/State
ZIP
E-mail
Tel
FAX

wish to apply for the following type of VISA:

  

and request the Italian Consulate General in Los Angeles to waive the requirement for me to appear in person at their offices for the following reason(s) :

In case of approval of this application by the Italian Consulate General in Los Angeles, I will send all my  papers in an AIR FEDEX envelope and arrangements will be made 

for a pre-paid AIR FEDEX return envelope.

The undersigned will not hold the Italian Consulate General in Los Angeles responsible in case of  loss of the above mentioned passport.

The undersigned has also reviewed all the requirements relative to the type of visa he is applying for.

Date:   dd/mm/yyyy      Signed:............................................................................


For official use: CONSULATE GENERAL OF ITALY – LOS ANGELES

       Authorized not to appear in person

       Not authorized – has to make appointment and come in person

 Date:                                                                            Signature