It Is a Pleasure to Offer You the Following Proposal for Your Visit to Moscow

Passports for minor Russian children adopted by US citizens/residents and permanently residing in the US are issued on the basis of their parents’ application. Please fill out the order form below. Do not leave any fields blank. We ask you to complete as much information as possible, however, if the answer is "none" or "does not apply" please write "none" or "does not apply".

Please Note: All parent applicants will need a valid US passport to apply. Go To Russia Travel can assistU.S. citizens with a full range of expedited passport services including obtaining a new USpassport and
USpassport renewal.

Parent Information:
1. Last, First, Middle names as it appears on your passport:

______
2. Date of Birth (dd/mm/yy) ______

3. Gender: M____ F_____
4. Place of Birth: ______
5. Passport information
Passport number: ______
Date of issue: ______Exp. date:______
Issued by: ______
6. Employment place and address:
Employer Name: ______
Street address andsuite number: ______
City:______State:______Zip:______

Position: ______
7. Residence address: ______
City:______State______Zip______
Phone: ______
Child Information:
8. Last, First, Middle names as itappears on child's passport:

______
9. Date of Birth (dd/mm/yy) ______

10. Gender:M_____F______
11. Place of Birth: ______
12. Adoption Certificate:
Serial Number: ______
Where issued (Country/City) ______
Certificate Number: ______
Date of issue(dd/mm/yy) ______
IssuingAuthority: ______
13. Child Russian Passport Information:
Serial Number:______Issue Date (dd/mm/yy)______Exp. Date (dd/mm/yy)______
Issued by (Country/Region/Province/State):

Issuing Authority

______
14. ChildSchool information ______
Started attending school (dd/mm/yy)______
School name: ______Current Level______
Address:______
City:______State: ______Zip______

Second Parent Information:
15. Is the Second Parent information available?: Yes ______No______
If No, give reason for the absence ofinformation:
______

If your answer to the above question is "YES" then complete the following information:
16. Last, First, Middle Name______
17. Residence address:______
Street Address:______
City:______State:______Zip:______
18. Passport information:
Passport number: ______
Issued by (Country/Region/Province/State)______

Date of Issue (dd/mm/yy)______Date of Exp. (dd/mm/yy)______

IssuingAuthority:______
6. Employment information:
Employer Name:______
Street address andsuite number:______
City:______State______Zip:______
Telephone:______
Position:______

19. Comments: ______
Form completed by: ______

______(parent signature)
Date: dd/mm/yy ______