Form Pa-1 - Passport Application Form - Palau Passport Office (Page 2 of 2) in pdf

FOR PASSPORT OFFICE USE ONLY

[ ]- REGULAR

[ ] - OFFICIAL

[ ] - DIPLOMATIC

[ ] - EXTENSION [ ] - AMENDMENT [ ] - NEW PASSPORT

PASSPORT NUMBER:_________________________ ISSUANCE DATE:__________________ EXPIRATION DATE:________________

Receipt No.:__________________ Date paid:______________ Issued by:_____________/______________ ENTERED:_________________

DO NOT WRITE ABOVE THIS LINE

PALAU PASSPORT OFFICE

Ministry of State

P. O. Box 100 Koror, Republic of Palau 96940

Tel No. 680-488-6330/8092 Fax No. 680-488-2443 Email:

Web:

PASSPORT APPLICATION

HOW TO APPLY FOR A PASSPORT OF THE REPUBLIC OF PALAU

Passports of the Republic of Palau are issued only to citizens of the Republic of Palau. Each person must obtain his or her own passport.

IF YOU ARE A FIRST TIME APPLICANT, please complete and submit this application personally with:

(1)

PROOF OF PALAU

CITIZENSHIP;

(2) PROOF OF IDENTITY; (3) ONE COLOR PHOTOGRAPH; (4) FEE. Check visa requirements with consular

offices to be visited.

PROOF OF CITIZENSHIP

(a)

APPLICANTS BORN IN PALAU

Submit previous Palau passport or birth certificate. A birth certificate must include your given name and surname, date

and place of birth, name of parent(s), date the birth record was filed, and seal or other certification of the official

custodian of such record.

IF NO BIRTH RECORD EXISTS,

submit baptismal certificate, or early census record along with notarized

affidavits of persons having knowledge of your birth. Evidence should include your given name and surname, date and

place of birth, and seal or other certification of office and signature of issuing official.

(b)

APPLICANTS BORN OUTSIDE OF THE REPUBLIC OF PALAU

In addition to the documents required in (a) above, submit your previous Palau passport, if any, Certification of

Naturalization;

Certificate of Citizenship, or evidence described below:

IF YOU CLAIM CITIZENSHIP THROUGH BIRTH ABROAD TO ONE OR MORE

PARENTS OF RECOGNIZED PALAUAN ANCESTRY,

submit proof of parent(s) citizenship, parent(s)

birth certificates, and affidavit of Palauan parent(s) showing all periods and places of residence/physical presence in

the Republic of Palau and abroad.

If your name is not the same as on your birth certificate, provide certified documents showing the reason. (e. g. Marriage

Certificates, Court Decrees, etc.)

Altered documents are not acceptable.

PROOF OF IDENTITY

If you are not personally known by the staff of the Passport Office, you must establish your identity to their satisfaction. You may

submit items such as the following containing your signature and physical description or photograph which is a good likeness of

you (e. g. Previous passports; Identification card, Drivers License or Certificate of Naturalization). Altered documents are not

acceptable.

IF YOU CANNOT PROVE YOUR IDENTITY

as stated above, you must appear with an IDENTIFYING WITNESS, a

Palauan citizen who has known you for at least two (2) years. Your witness must prove his or her identity and complete and sign

an “Affidavit of Identifying Witness” before the Clerk of Court.

3. ONE PHOTOGRAPH

Submit one photograph of you, sufficiently recent (taken within the last six (6) months) to be a good likeness of you. It must bear

a size of 2”x2”. Photographs must be a clear, front view, full face, taken in normal street attire without a hat or dark glasses, and

printed on thin paper with a plain light (white) background. Photograph must be in color. Photographs retouched so that your

appearance is changed are unacceptable. Snapshots, most vendor machine prints, and magazine or full-length photographs are

unacceptable.

4. FEES

Passport Fee is $50.00.

Renewal Fee is $50.00.

Amendment/Validation is $25.00.

Replacement is $75.00.

Official and Diplomatic passports, no fee.

Pay the passport fee at the National Treasury, Republic of Palau or in one of the following methods:

Bank draft or cashier’s check; Money Order (United States Postal, International Currency Exchange); United States currency.

Make fees payable to the National Treasury, Republic of Palau.

Failure to provide the information requested on this form may result in the denial of a Palau passport, related document, or service.

FORM

PA-1

PASSPORT APPLICATION FORM – ROP/Rev. Jan.2005

Form Pa-1 - Passport Application Form - Palau Passport Office Page 2

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