Hi, here is the form you have to fill to personalize the ...



---------------- FORM STARTS ------- FBI CREDENTIALS – DATA FORM -------------------

  

Fill one form for each id card you purchase – read the instructions before!

IF YOU HAVE ORDERED LAMINATION, REMEMBER THAT CARDS CANNOT BE FURTHER CUSTOMIZED ONCE LAMINATED

 

 

- FILL WITH ‘X’ WHERE BRACKETS [ ] APPEAR

- IF YOU WANT TO LEAVE BLANK A FIELD ANSWER WITH: ‘N/A’

- IF YOU WANT TO LEAVE US TO INSERT SOME DATA (FOR EXAMPLE ‘CARD NUMBER’ OR ‘SERVICE NUMBER’) THEN ANSWER WITH THREE SLASHES: ‘///’

PLEASE  FILL  ALL  SPACES

 

CUSTOMER NAME :

write the same name shown on your paypal home address

 

TYPE OF ID CARD

mark ONE of the following options

 

- FBI CREDENTIALS, ’40-’60, ACTIVE DUTY PERSONNEL [ ]

- FBI CREDENTIALS, ’40-’60, RETIRED PERSONNEL [ ]

- FBI CREDENTIALS, ’70-’90, ACTIVE DUTY PERSONNEL [ ]

- FBI CREDENTIALS, ’70-’90, RETIRED PERSONNEL [ ]

- FBI CREDENTIALS, ’70-’90, CONSULTANTS [ ]

- FBI CREDENTIALS, VOIDED, ’70-’90, CONSULTANTS [ ]

- FBI CREDENTIALS, ’70-’90, HIGHER RANKS [ ]

- FBI CREDENTIALS, MODERN ERA, ACTIVE DUTY PERSONNEL [ ]

- FBI CREDENTIALS, MODERN ERA, RETIRED PERSONNEL (“RETIRED” IN RED LETTERS) [ ]

- FBI CREDENTIALS, MODERN ERA, RETIRED PERSONNEL (“RETIRED” IN BLACK DOTS) [ ]

- FBI CREDENTIALS, MODERN ERA, CONSULTANTS [ ]

- FBI CREDENTIALS, MODERN ERA, HIGHER RANKS [ ]

- FBI TASK FORCE CREDENTIALS, TYPE 1, MODERN ERA [ ]

- FBI TASK FORCE CREDENTIALS, TYPE 2, MODERN ERA [ ]

- FBI ID CARD, ACTIVE DUTY PERSONNEL, MODERN ERA, BLUE [ ]

- FBI ID CARD, ACTIVE DUTY PERSONNEL, MODERN ERA, GREEN [ ]

- FBI ID CARD, ACTIVE DUTY PERSONNEL, MODERN ERA, YELLOW [ ]

- FBI ID CARD, RETIRED PERSONNEL [ ]

PHOTO SECTION

NOTE: PHOTO WILL BE PRINTED IN “BLACK & WHITE” ON ’40-’60 CREDENTIALS

AND IN “COLORS” ON ’70-‘90 AND MODERN ERA CREDENTIALS

PHOTO REQUIRED (ANSWER WITH ‘YES’ OR ‘NO’):

IF ANSWER IS ‘YES’ please send the photo together with this form (or insert it in the white space on last page of this form), to the email address shown in the contact us section on (.JPG OR .BMP FORMAT, NO LOW RESOLUTION IMAGES)

GENERAL DATA SECTION

 

NAME:

RANK:

SERIAL NUMBER:

ISSUE DATE

- DAY:

- MONTH (in digits):

- YEAR:

EXPIRATION DATE

- DAY:

- MONTH (in digits):

- YEAR:

RETIREMENT DATE:

- DAY:

- MONTH (in digits):

- YEAR:

Some data may not be used because not necessary. Just to be sure, please fill all sections.

SIGNATURE OF BEARER SECTION

SIGNATURE OF BEARER REQUIRED [ ]

IF YOU MARK THIS OPTION, please send the scansion of the signature together with this form (or insert it in the white space on last page of this form), to the email address shown in the contact us section on (.JPG OR .BMP FORMAT, NO LOW RESOLUTION IMAGES)

ADD SIGNATURE OF BEARER FOR ME [ ]

Option AVAILABLE only if you have NOT MARKED the ABOVE OPTION. By selecting this option, you do not have to attach any image, we will provide to sign the card. Signature will read the same first name, last name and middle name initial specified above.

NO SIGNATURE OF BEARER REQUIRED [ ]

SIGNATURE OF BEARER WILL NOT APPEAR ON CARD.

SIGNATURE OF ATTORNEY GENERAL SECTION

AVAILABLE ONLY FOR FBI DIRECTOR CREDENTIALS

SIGNATURE OF ATTORNEY GENERAL REQUIRED [ ]

IF YOU MARK THIS OPTION, please send the scansion of the signature together with this form (or insert it in the white space on last page of this form), to the email address shown in the contact us section on (.JPG OR .BMP FORMAT, NO LOW RESOLUTION IMAGES)

ADD SIGNATURE OF ATTORNEY GENERAL FOR ME [ ]

Option AVAILABLE only if you have NOT MARKED the ABOVE OPTION. By selecting this option, you do not have to attach any image, we will provide to sign the card with a random name.

NO SIGNATURE OF ATTORNEY GENERAL REQUIRED [ ]

SIGNATURE OF ATTORNEY GENERAL WILL NOT APPEAR ON CARD.

SIGNATURE OF FBI DIRECTOR SECTION

AVAILABLE ONLY FOR FBI CREDENTIALS, ’40-‘60

SIGNATURE OF DIRECTOR REQUIRED [ ]

IF YOU MARK THIS OPTION, please send the scansion of the signature together with this form (or insert it in the white space on last page of this form), to the email address shown in the contact us section on (.JPG OR .BMP FORMAT, NO LOW RESOLUTION IMAGES)

ADD SIGNATURE OF DIRECTOR FOR ME [ ]

Option AVAILABLE only if you have NOT MARKED the ABOVE OPTION. By selecting this option, you do not have to attach any image, we will provide to sign the card with a random name.

NO SIGNATURE OF DIRECTOR REQUIRED [ ]

SIGNATURE OF DIRECTOR WILL NOT APPEAR ON CARD.

REMARKS

ONCE YOU WILL GIVE US YOUR DATA AND THEY WILL BE PRINTED ON THE ID CARD THEY CANNOT BE REMOVED OR MODIFIED IN ANY WAY. SO PLEASE CHECK DOUBLE TIME THE INFORMATION YOU GIVE IN THIS FORM.

INFORMATION PROVIDED IN THIS FORM WILL REMAIN STRICTLY CONFIDENTIAL

 

---------------- FORM ENDS ------- FBI CREDENTIALS – DATA FORM -------------------

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