Fillable Application For A U.s. Passport By Mail (Page 2 of 6) in pdf

WARNING: False statements made knowingly and willfully in passport applications, including affidavits or other documents submitted

to support this application, are punishable by fine and/or imprisonment under the provisions of 18 USC 1001, 18 USC 1542, and/or 18

USC 1621. Alteration or mutilation of a passport issued pursuant to this application is punishable by fine and/or imprisonment under

the provisions of 18 USC 1543. The use of a passport in violation of the restrictions contained therein or of the passport regulations is

punishable by fine and/or imprisonment under 18 USC 1544. All statements and documents are subject to verification.

WHAT DO I SEND WITH THIS APPLICATION FORM?

- Your most recent U.S. passport book and/or U.S. passport card

- A marriage certificate or court order if your name has changed

- Fees

- Two recent, color photographs

(Please visit our website at travel.state.gov for detailed information regarding current fees.)

See below for more detailed information.

YOUR MOST RECENT U.S. PASSPORT (BOOK AND/OR CARD FORMAT). Submit your most recently issued passport book and/or passport card.

When submitting a passport book and/or passport card with this form, please verify that the document was issued at age 16 or older in your current

name (or see item #2 below) and issued within the past 15 years. If your U.S. passport is damaged, you must apply on the DS–11 Application form as

specified below.

A MARRIAGE CERTIFICATE OR COURT ORDER. If the name you are currently using differs from the name on your most recent passport, you

must submit a marriage certificate or court order showing the change of name. The name change document may be a certified copy or a complete and

unaltered photocopy showing a seal and officiate/judge signature. All documents will be returned to you by mail. 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

or State court of record or any probate court accepting passport applications; or (3) a Post Office which has been selected to accept passport applica-

tions.

THE CURRENT PASSPORT FEE. Enclose the fee in the form of a personal check or money order. MAKE CHECKS PAYABLE TO “DEPARTMENT OF

STATE.” THE FULL NAME AND DATE OF BIRTH OF THE APPLICANT MUST BE TYPED OR PRINTED ON THE FRONT OF THE CHECK. DO

NOT SEND CASH. Passport Services cannot be responsible for cash sent through the mail. By law, the fees are non–refundable.

OVERNIGHT DELIVERY SERVICE: If you desire overnight delivery service for the return of your passport, please include the appropriate fee with your

payment.

FASTER PROCESSING: For an additional fee, you may request expedited service. Please include this fee in your payment and submit the application to

the appropriate address. Please write “Expedite” on the outer envelope when mailing. Also, TO ENSURE MINIMAL PROCESSING TIME

for expedited applications, Passport Services recommends using overnight delivery when submitting the application AND including

the appropriate postage fee for return overnight delivery for the completed passport book or passport card. Expedited service is available

only in the United States. Please visit our website for updated information regarding fees and service times.

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 and information regarding affixing the photograph to the

application.

NOTE:

If you choose to provide your e–mail address in Item #8 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.

WHERE DO I MAIL THIS APPLICATION?

ROUTINE SERVICE

EXPEDITED SERVICE (Additional Fee)

MAIL THIS FORM TO: