Embassy 0f Ethiopia

Document Authentication Registration Form

Page 1 of 2

Whose Document is it?

Personal

Company

Personal Information

First Name /In English/

Middle Name /in English/

Last Name /in English/

Sex

Date of Birth

Occupation

Place/Country of Birth

Current Nationality

Address in US

Home/Mailing Address

City

State

Zip/Postal Code

Contact Information

Day Tel.

Email

Page 2 of 2

Document Information

Document Category

Doc. Authenticated By

Reference No.

Document Copy

Ethiopian ID Information

Do You Have Ethiopian Passport or Origin ID?

Yes

No

If yes payment will be less.

ID Information

ID /Green Card/Driving License Number

Expired Date

ID /Green Card/Driving License Copy