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To allow us to best help you obtain Notary services for Form 1583 which is required by the US Postal Service, please complete this form:

First (Given) Name:

Last (Sir) Name:

Company Name (if applies):

Did you contact a US Embassy or US Consulate?     (radio button - no default)

City and Country where US Embassy or Consulate is located?

Telephone number you called (please include area/city code)?

Person who you spoke with (if possible, let us know any title or department name)?

Do you speak basic English?

If you do not speak basic English, what is the full name of the person who will travel to get the form notarized who does speak basic English?

What is your telephone number (please include area/city code)?

What is your fax number (please include area/city code)?

What is your e-mail address?

What time of day are you available to visit the US Embassy or Consulate  (local time- tick all that applies) (tick boxes)

_08.00 - 11.00    _10.00 - 13.00    _12:00 - 15.00    _15.00 - 18.00

Please describe the problem you have encountered

(Submit)