Us Passport Application Form printable pdf download

Us Passport Application Form

To: U.S. Department of State

Passport Agency

I,_______________________________________________________________________________ ,

bearer of current US passport number __________________________ issued on _______________ am

currently scheduled to travel internationally to the following places on the following dates:

_______________________________________________________________________________

I will need to obtain visas in conjunction with my planned travel to the countries listed below. Because of

the time required to process the necessary visas it is not practical for me to use my existing passport for

other planned international travel during significant periods.

I respectfully request that you issue a second passport for my use to obtain the necessary visas and/or to

facilitate my travel while visas are being processed in my existing passport.

Should either passport be lost or stolen, I will report the circumstances immediately to the Passport

Agency, or, if abroad, to the nearest American Embassy or Consulate General.

I understand that both passports must be submitted for inspection or cancellation when I request any

passport service in the future.

Thank you.

________________________________________

Signature of Applicant

________________________________________

Signature of parent if applicant is under age 18

Complete if Applicable:

I am requesting that my application for passport be expedited, as I will also be required to apply for visas

for the following countries:

_______________________

Us Passport Application Form