Form Ds-5504 - Us Passport Re-Application Form (Page 2 of 6) in pdf

What do I need to send with this application form?

YOUR MOST RECENT U.S. PASSPORT ISSUED LESS THAN ONE YEAR AGO.

TWO RECENT, COLOR PHOTOGRAPHS. Submit two color photographs of you alone, sufficiently recent to be a good likeness

of you (normally taken within the last six months), and 2x2 inches in size. The image size measured from the bottom of your chin

to the top of your head (including hair) should not be less than 1 inch and not more than 1 3/8 inches. The photographs must be

color, clear, with a full front view of your face, and printed on thin paper with plain light (white or off-white) background.

Photographs must be taken in normal street attire, without a hat, head covering, or dark glasses unless a signed statement is

submitted by the applicant verifying the item is worn daily for religious purposes or a signed doctor’s statement is submitted

verifying the item is used daily for medical purposes.

Photographs retouched so that your appearance is changed are

unacceptable. Snapshots, most vending machine prints, and magazine or full-length photographs are unacceptable. Digitized

photos must meet the previously stated qualifications and will be accepted for use at the discretion of Passport Services. (Visit

our website for details.)

EVIDENCE TO SUPPORT A NAME CHANGE OR OTHER CHANGE IN DESCRIPTIVE DATA.

•

If your name has changed you must submit a marriage certificate or court order showing the change of name. If you are

unable to document your name change in this manner, you must apply on the DS-11 Application form by making a personal

appearance at (1) a passport agency; (2) any Federal, State, or county court of record or any probate court accepting passport

applications; or (3) a Post Office which has been selected to accept passport applications.

•

If there is a change or an error in the descriptive data in your recently issued passport you must submit the appropriate

evidence showing the correct information (e.g. birth certificate or marriage certificate).

•

All documents submitted for a name change or a data correction MUST bear the official seal of the issuing authority.

Uncertified copies or notarized documents cannot be accepted. All documents will be returned to you with your passport.

PLEASE NOTE: If you are re-applying because your U.S. passport was limited in validity due to a lack of citizenship

evidence or identity, please submit the necessary documentation as specified by Passport Services.

Please contact the

National Passport Information Center for detailed information and instructions.

How do I apply using this form?

1. C

OMPLETE

SIGN AND DATE THIS FORM

MOST RECENT U.S.

END

HIS FORM WITH YOUR

PASSPORT

ANY REQUIRED ADDITIONAL EVIDENCE

AND TWO RECENT COLOR

PHOTOGRAPHS

MAIL THIS FORM TO:

FOR DELIVERY—OTHER THAN U.S. POSTAL SERVICE:

National Passport Processing

P.O. Box 13290

1617 Brett Road

Philadelphia, PA 19101-3290

ATTN: Department 13290

New Castle, DE 19720

Is there a fee associated with this form and

how will my new passport be mailed back to me?

• There is no fee associated with the use of this form. Your re-issued U.S. passport and any documentary evidence

submitted to Passport Services will be returned to you by priority mail.

• For faster processing, you may request Expedited Service. Expedite requests will be processed in three workdays

from receipt at the Passport Center. The fee for expedited service is $60. Enclose the $60 expedite fee in the form

of a personal check or money order. All fees should be payable to the “U.S. Department of State.” Do not send cash.

Expedited Service is available only in the United States.

• If you desire Special Postal Service (overnight mail, special delivery, etc.) include appropriate postage fees or a pre-

paid envelope.

NOTE: The Passport Center will not mail a passport to a private address outside the United States.

NOTE: If you choose to provide your e-mail address in Item #11 on this application, Passport Services will only use

that information to contact you in the event there is a problem with your application or if you need to provide

additional information to us.

DS-5504

Instruction Page 2 of 4

Form Ds-5504 - Us Passport Re-Application Form Page 2

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