Application Form for an Apostille/State Seal on Transcripts

Application Form for an Apostille/State Seal on Transcripts
Complete this form and send it along with:
 UPENN Transcript Request Form
 University of Pennsylvania Fee
 Commonwealth of PA Fee
Mail to: Office of the University Registrar
University of Pennsylvania
3451 Walnut Street
150 Franklin Building
Philadelphia, PA 19104-6291
Name: ___________________________________________________Date: _______________
Country that Requires the Apostille/State Seal: ________________________________________
Penn ID Number (not Social Security Number): _______________________________________
Date of Birth: __________________________________________________________________
Mailing Address: _______________________________________________________________
_______________________________________________________________
_______________________________________________________________
Email Address: ________________________________________________________________
Tele No: ______________________________________________________________________
Please send completed transcript to (if not to Mailing address above):
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
University Fees: (dependent upon return delivery option selected)
 $60.00 (includes transcript, notary & delivery fees to Harrisburg as well as Express
return delivery to a US address).
 $90.00 (includes transcript, notary & delivery fees to Harrisburg as well as Express
return delivery to an International address).
 Payment should be made by Check or Money Order in US Dollars; payable to “Trustees
of the University of Pennsylvania.” We cannot accept credit card payments.
Commonwealth of PA Fees:
 A second check payable to “Commonwealth of Pennsylvania” in the amount of $15.00
(per document to be sealed) must be included to cover the costs assessed in Harrisburg.