U.S. Department of State
U.S. PASSPORT RE-APPLICATION FORM
PLEASE DETACH AND RETAIN THIS INSTRUCTION SHEET
FOR YOUR RECORDS.
Date of Application:
CAN I USE THIS FORM?
Complete this checklist to determine your eligibility to use this form.
1. My most recent U.S. passport was issued less than one year ago.
2. I can submit my most recent U.S. passport.
I have had a change in my name;
My identifying information was printed incorrectly;
My most recent U.S. passport was limited in validity for one year or less
and/or issued abroad.
If you answered NO to any of the three statements above,
STOP - You cannot use this form!!!
You must apply on application form DS-11 or DS-82 depending on your circumstances. Please refer to those
forms, visit our website, or contact the National Passport Information Center for further information.
FOR INFORMATION, QUESTIONS, AND INQUIRIES:
Please visit our website at travel.state.gov. In addition, contact the National Passport Information Center (NPIC) toll-free at
1-877-487-2778 (TDD: 1-888-874-7793) or by e-mail at NPIC@state.gov. Customer Service Representatives are available
M-F, 8AM-8PM EST (excluding Federal holidays). Automated information is available 24/7.
NOTICE TO APPLICANTS RESIDING ABROAD
United States citizens residing abroad CANNOT submit this form to the passport facility listed on instruction page 2. Such
applicants should contact the nearest United States embassy or consulate for procedures to be followed when applying
CAREFULLY FOLLOW THE INSTRUCTIONS ON THE REVERSE OF THIS PAGE.
READ ALL WARNINGS, NOTICES, AND STATEMENTS ON INSTRUCTION PAGES 3 AND 4.
INCOMPLETE OR UNACCEPTABLE APPLICATIONS WILL DELAY THE ISSUANCE OF YOUR PASSPORT.
Instruction Page 1 of 4