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HTML Preview Release Of Liability Form page number 1.
1
Release of Liability
T
o: Consulate General of Japan in New Y
ork
I
will not
hold the Consulate General of Japan in New Y
ork liable for any loss or
dama
ges of my d
ocuments whi
le b
eing transp
orted t
o or fro
m the Cons
ulate by
mailin
g
services.
I
t
a
k
e
full
responsibility for the transportation of these documents.
Print
Name
in
full:
_______________________ _______________________ ______________
(
S
u
r
n
a
m
e
)
(
G
i
v
e
n
n
a
m
e
)
(
M
i
d
d
l
e
n
a
m
e
)
Date:
________________
S
i
g
n
a
t
u
r
e
:
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*****
Y
our signature h
ere must be exactly the same as in you
r passport.
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