Republic Of Texas Passport Form - Nation Of Texas (Page 2 of 4) in pdf

Pg. 2

(Form RTPAi-040311)

INSTRUCTIONS

(Please read these instructions BEFORE ﬁlling out the Application Form)

(Please refer to the Passport Eligibility Policy Statement, to conﬁrm your eligibility.)

Include the following documentation with your application:

1. Copy of Declaration of Nationality, declaration of citizenship or other document showing Texas Nationality (See form online.)

(if you don't have one, or have lost one already done previously, download and execute the form provided on our website).

2. Copy of evidence of birth. [e.g.: early baptismal or circumcision certiﬁcate; hospital birth record, early census, school, or family Bible record;

newspaper or insurance ﬁles; or witnessed afﬁdavit(s) of two people having knowledge of your birth. Evidence should include your given name(s)

and family name(s), date and place of birth, and names of parents.

3. Two identical photographs – must be of you alone, sufﬁciently recent to be a good likeness of you (taken within the last 6 months), and 2X2

inches in size. The image size measured from the bottom of the chin to the top of the head (including hair) should not be less than 1 inch and not

more than 1-3/8 inches. Photographs must be clear, front view, full face, taken in your travel (or respectable street) clothes (no T-Shirts, please),

without a hat or dark glasses, and printed on thin photo paper with a plain light (white or off-white background. They may be in color or black and

white. They must be capable of withstanding a mounting temperature of 225° Fahrenheit (107° Celsius). Retouched photographs 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 the Secretary of State or his designee.

4. Fee – As of February 5, 2004, Contribution is set at: TS6.25 (25-8g coins Texas Silver), OR: 10 troy oz. of .999 Fine Silver, OR: Postal Money

Order for $75 (for a single passport). Spouses are TS5.50 (22-8g coins Texas Silver), OR: 8 troy oz. of Fine Silver, and children & other dependents

living with parents are TS5.00 (20-8g coins Texas Silver), OR: 7 troy oz. of Fine Silver. ($60/$52.50 PMO)

FILLING OUT THE APPLICATION

Every line must be properly ﬁlled out (typed or printed neatly – except for signatures). On any line that does not apply to you, write N/A.

(1b) Applicant’s Given Names are the names given to you at birth or taken on subsequently, and normally written before your Surname(s), Family or

Clan name(s).

(3) Status - If you do not (or no longer) have a mate, circle "SINGLE." You are "MARRIED" if you currently have a mate (whether you have been

ofﬁcially – legally and/or religiously - joined or not). NOTE: This is natural (common) law.

(4a) Domicile or Address – physical location or street and number where you call “home.” (No P.O. Boxes on this line)

(4b) Town - The town where your postal worker picks up mail just before it is delivered to you.

(4c) Mailing Location or Address – where you want the passport mailed to. Include zip code. (This could be a P. O. Box)

(6) Occupation – What you do to make a living, or if retired, your former occupation; or “Student.”

(9c, 10c) Father’s & Mother’s Nationality (Citizenship) – If they are Declared Texian Nationals, the answer is: Texian. Otherwise, their country or

state of birth, or the country in which they hold citizenship. If in one of the several continental united States, the name of the state will do, otherwise

just the name of the country, e.g.: Texas, Mexico, Hawaii, Canada, Puerto Rico, etc. NOTE: This is NOT a reference to race or ethnic ancestry.

If the application is for a child (under age 18), the information provided on the application will be for the child.

The signature authenticating the information on the form will be that of the applicant 18 years of age or older, or that of a child's parent or guardian.

(13a) The authenticating signature will be done before two witnesses (14a-15c), preferably Texian Nationals.

Please mail the application to: Republic of Texas, S.O.S., P.O. Box 100, Overton, Texas [75684-0100]

Further information will be found on the Republic of Texas Web Site:

OR call: 903-834-3592, OR 1-888-802-6352

Your passport will be sent to the mailing address you provided on the application.

It is strongly recommended that the passport be signed on delivery, by the Applicant/Guardian.

It is suggested that the passport be renewed at least once every 10 years, to reﬂect changes in your appearance or other information, such as

domicile, name change, etc. (The photo must look just like you when you travel.)

Applicant may contact the Secretary of State or his designee for a form to modify Applicant’s information. The Republic of Texas web site will

inform you on these matters.

Please contact the issuing ofﬁce or the Secretary of State to report the loss, theft or destruction of any passport.

NOTE: Your private information will be kept in the strictest conﬁdence, under lock and key.

Republic Of Texas Passport Form - Nation Of Texas Page 2

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