Apostia
Apostia
Apostia
11/2022
NOT FOR USE IN
REQUEST FOR OFFICIAL
PROCEEDINGS RELATING
CERTIFICATE OR APOSTILLE
TO THE ADOPTION OF ONE
OR MORE CHILDREN
PLEASE SUBMIT THIS REQUEST FORM WITH THE DOCUMENTS, THE PAYMENT AND THE RETURN ENVELOPE.
Contact Information:
Name:
Mailing
Address:
Street
City State
Texas Zip Code
Phone: Email Address:
Required:
Write name of EMBASSY or COUNTRY where documents will be presented:
✔ Complete Credit/Debit Card Information: (Fees paid by credit card are subject to a statutorily authorized convenience fee of 2.7% of the total
fees incurred.)
Type: ✔ VISA AMX MAST DISC
Card #:
Exp: (MM/YY) Security Code:
Name on Card:
Billing Address:
City/State: Zipcode:
Signature:
Mailing Address: Physical Address: (for overnight mail and walk-in service)
Office of the Secretary of State Office of the Secretary of State
Authentications Unit Authentications Unit
PO Box 13550 1019 Brazos St
Austin, TX 78711-3550 Austin, TX 78701
(512) 463-5705
Form 2102