Passport Verification Form

Passport Verification Form

This Passport Verification Form documents the agreement between the parties for the inspection and certification of a passport document. Applicant Name: and Verifier Name: .

Recitals

WHEREAS, Applicant seeks formal verification of passport identity information for the purpose of identity confirmation, regulatory compliance, or other lawful business purposes; the passport presented is Passport Number: issued by on and expiring on .

WHEREAS, Verifier is willing to examine the original passport document, confirm the facial likeness and document authenticity to the extent reasonably practicable, and provide a written verification statement subject to the terms and conditions below.

Scope of Work

Verification Procedure and Applicant Representations

Applicant affirms that the passport presented to Verifier is the original, has not been materially altered, and that the information provided herein is true and complete. Applicant will present the original passport for physical inspection at the time and place agreed by the parties. Applicant authorizes Verifier to make a photocopy or electronic scan of the passport for the limited purpose of completing the verification and recordkeeping.

Applicant consents to a copy or scan of the passport being retained by Verifier for recordkeeping and audit purposes.

Payment Terms

The parties agree that the verification services described in this form will be provided for the fee set forth below.

Term and Termination

This Agreement commences on Start Date: and continues until End Date: unless earlier terminated in accordance with this section.

Either party may terminate this Agreement on provision of written notice not less than days to the other party. Verifier may immediately terminate if Verifier reasonably suspects fraud, forgery, or document alteration. Termination does not relieve Applicant of payment obligations for services already rendered.

Confidentiality

Each party shall keep confidential all non-public information and copies of identification documents exchanged under this Agreement and shall not disclose such information to third parties except (a) as required by law or regulation, (b) with the prior written consent of the disclosing party, or (c) to professional advisors bound by confidentiality. Verifier will safeguard retained copies against unauthorized access and will retain records only for the period required by applicable recordkeeping policies or law.

Warranties; Limitation of Liability

Verifier warrants that it will perform verification services with reasonable care and in accordance with its standard practices. Except for willful misconduct or gross negligence, Verifier's total liability arising out of or in connection with this Agreement shall not exceed the fees actually paid for the specific verification service giving rise to the claim. Applicant acknowledges that Verifier's verification is based on the documents presented and visual inspection and cannot guarantee future or third-party acceptance of the passport.

Governing Law

This Agreement shall be governed by and construed in accordance with the laws of , without regard to conflicts of law rules.

Entire Agreement

This instrument, including any attachments and the Verification Statement issued by Verifier, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, proposals, and communications, whether written or oral.

Applicant Certification

I certify under penalty of perjury that the passport presented is mine (or I am authorized to present it), that the information I have provided is true and accurate, and that I authorize the Verifier to perform the actions described in this form.

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