ID Card Authorization Form

Please fill out this form, then submit electronically. You may also email a signed copy to authorization@pasp365.com or fax to 912-537-4894.

I authorize and accredit the Police & Sheriffs Press, Inc. to produce ID Cards for the:

Agency Name: Head of Agency: Date: Shipping Address: City: State, Zip: Phone Number: 24 Hour Number: Fax Number: Email Address: Number of Employees:

Employee listing (optional — one name per line)

Design Choice: Flag Generic — free set-up State Outline Generic — free set-up State Outline — $150.00 set-up fee Custom

Head of Agency please sign in the center of the box below.

Printed name (must match Head of Agency):

Use your finger or stylus. Sign in the center of the box.