Lost Or Stolen Passport Instructions - American Visa Of Dc

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AMERICAN VISA OF DC
1801 Columbia Rd., NW #200, Washington, DC 20009
Tel: 202-462-5908
Fax: 202-387-5430
Email:
or
_____________________________________________________________________________________________________
THIS IS NOT AN APPLICATION; IT IS ONLY A COVERING LETTER FOR AMERICAN VISA OF DC
Replace Lost or Stolen U.S. Passport
Required Documents Checklist:
Original or state certified copy of a US birth certificate or expired U.S. Passport.
One signed
U.S. Passport application (DS 11)
completed online and bar-coded.
One signed and completed form DS 64 (this should print out at the same time as the DS 11).
An authorization letter signed and dated.
Copy of the flight itinerary from a travel agent/airlines or an original letter with an original signature, from the employer describing
the proposed trip, if traveling on business.
Required Process Checklist:
Take all of the documents listed above to a nearby US Post Office that is a passport acceptance agent or a County Clerk of Court’s
office (appointments are often required).
After presenting these documents, when requested, sign the application and attest to the truthfulness of the information on the
application and present current government issued ID (e.g. driver’s license).
The acceptance agent will collect, separately, a $25 processing fee, and then the US Government fee. These fees are listed in the
chart below as a total amount in the section “Government Fee”.
The acceptance agent will then seal everything into an envelope for security purposes. No one can open this envelope except the
Department of State. Once sealed, it must be presented to the Department of State within 5 business days. The agent will return the
sealed envelope to the applicant so that it may be “hand carried” by American Visa of DC.
Final Instructions Checklist:
Place the sealed envelope, this work order form and any other notes or instructions and send to American Visa of DC.
For 24 hour or Same Day Requests: Contact our office for a reservation. Packages must be sent by FedEx First Overnight
service, signature release, at our hold for pick up location: American Visa of DC, Attn: Passport Processing, 1812 Adams Mill
Road NW, Washington DC 20009. Email or fax us the tracking number.
Jurisdiction:
Residents of all states can be processed in Washington DC.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Contact Person’s Name: ______________________________ Phone and email: ___________________________________________
SHIPPING INSTRUCTIONS: Return completed process to:
Company Name (If applicable): ____________________________________ Contact Name ___________________________
Address______________________________________________________________ Apt#/Mail Code_____________________
City____________________________________ State __________________ Zip Code _______________________________
Phone #______________________________________ Email Address _____________________________________________
TRAVELER(S) INFORMATION:
Departure Date from U.S.A.: ___________ Need by this date: ___________ *Rush fees will be applied to meet this date if necessary
1) Last Name: _______________________________________
First Name _______________________________________
Passport #:_________________________ Passport Expires: ______________________ Date of Birth_____ /_____ / ________
2) Last Name: ________________________________________
First Name ________________________________________
Passport #:_________________________ Passport Expires: ______________________ Date of Birth____ /_____ / _________
Processing Fees: (check one):
Processing Time:
American Visa
Department of State
Department of State
Fed Ex
TOTAL
of DC Fee:
Fee (15yrs and Under):
Fee (16 yrs & older)
Shipping Fee
(Excluding Department
of State Fees)
8 – 14 Business Days:
$75
$165
$195
$30
$105
5 – 7 Business Days:
$125
$165
$195
$30
$155
2 - 4 Business Days:
$200
$165
$195
$30
$230
24 Hours or Same Day:
$250
$165
$195
$30
$280
PAYMENT: (check one):
I authorize American Visa of DC to charge my credit card for payment of passport services.
Card holders’ name _______________________________ Number __________________________ Exp. Date: ________________
Signature ________________________________________________________________________Today’s Date: ________________
Check or Money Order made out to “American Visa of DC” for $______________ enclosed.
My company has a prearranged billing agreement.
American Visa of DC Inc. assumes no responsibility for the loss, damage or delay of passports or visas caused by an Embassy, Consulate, Government Office,
postal or courier service, delivery service or travel agency. Requirements and fees relating to this request are subject to change without notice.

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