Form Ds11 - Application For Us Passport Or Registration printable pdf download

U.S. Department of State

OMB APPROVAL NO. 1405-0004

EXPIRATION DATE 03/31/2005

APPLICATION FOR U.S. PASSPORT OR REGISTRATION

ESTIMATED BURDEN: 20 MINUTES

(See Page 4)

HOW TO APPLY FOR A U.S. PASSPORT

PLEASE DETACH AND RETAIN THIS INSTRUCTION SHEET FOR YOUR RECORDS

I applied:

Place:

Date

(mm-dd-yyyy)

FOR INFORMATION, QUESTIONS, AND INQUIRIES:

Please visit our website at travel.state.gov OR contact the National Passport Information Center at 1-900-225-5674, For

TDD: 1-900-225-7778; or for credit card users: 1-888-362-8668, For TDD: 1-888-498-3648.

U.S. PASSPORTS ARE ISSUED ONLY TO U.S. CITIZENS OR NATIONALS. EACH PERSON MUST OBTAIN HIS OR HER OWN PASSPORT.

APPLICANTS WHO HAVE HAD A PREVIOUS U.S. PASSPORT:

If your most recent passport was issued less than 15 years ago and you were over 16 years old at the time of issuance,

you may be eligible to use Form DS-82 (mail-in application). Please inquire about eligibility when you apply or visit our

website as listed above. Address any requests for a passport amendment, extension of validity, or the addition of visa

pages to a Passport Agency or a U.S. Consulate or Embassy abroad. In advance of your departure, check visa

requirements with consular officials of the countries you will be visiting.

SPECIAL REQUIREMENTS FOR CHILDREN UNDER AGE 14 (As directed by Public Law 106-119.)

To submit an application for a child under age 14 both parents or the child's legal guardian(s) must

appear and present all of the following:

Evidence of child's U.S. citizenship,

Evidence of child's relationship to parents or guardian(s), AND

Parental identification

IF ONLY ONE PARENT APPEARS YOU MUST ALSO SUBMIT ONE OF THE FOLLOWING:

Second parent's written statement consenting to passport issuance for the child,

Primary evidence of sole authority to apply, OR

A written statement (made under penalty of perjury) explaining the second parent's unavailability.

FIRST TIME APPLICANTS:

Please complete and submit this application in person. Each application must be accompanied by:

(1) PROOF OF U.S. CITIZENSHIP

(2) PROOF OF IDENTITY

(3) TWO PHOTOGRAPHS, AND

(4) FEES (as explained on reverse) to one of the following acceptance agents: a clerk of a Federal or State court of

record or a judge or clerk of a probate court accepting applications, a designated municipal or county official, a

designated postal employee at an authorized post office, an agent at a Passport Agency in Boston, Chicago,

Honolulu, Houston, Los Angeles, Miami, New Orleans, New York, Norwalk CT, Philadelphia, San Francisco, Seattle,

or Washington, DC, or a U.S. consular official at a U.S. Embassy or Consulate, if abroad. To find your nearest

acceptance facility, visit our web site or contact the National Passport Information Center.

See Reverse Side for Detailed Information

PLEASE DETACH AND RETAIN THIS INSTRUCTION SHEET FOR YOUR RECORDS

DS-11

Page 1 of 4

08-2002

Form Ds11 - Application For Us Passport Or Registration

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