APPLICATION FOR A U.S. PASSPORT BY MAIL
PLEASE DETACH AND RETAIN THIS INSTRUCTION SHEET
FOR YOUR RECORDS.
Date of Application:
See Instruction Page 2 for Detailed Information
on the Completion and Submission of this Form.
INCOMPLETE OR UNACCEPTABLE APPLICATIONS WILL DELAY THE ISSUANCE OF YOUR PASSPORT.
If you answered NO to any of the four statements above,
STOP – You cannot use this form!!!
You must apply on application form DS–11 by making a personal appearance before an acceptance agent
authorized to accept passport applications. Visit travel.state.gov to find your nearest acceptance facility.
Instruction Page 1 of 4
NOTICE TO APPLICANTS RESIDING ABROAD
United States citizens residing abroad CANNOT submit this form to the Passport Facility listed on Instruction Page 2. Such
applicants should contact the nearest United States embassy or consulate for procedures to be followed when applying
FOR INFORMATION, QUESTIONS, AND INQUIRIES: Please visit our website at travel.state.gov. In addition,
contact the National Passport Information Center (NPIC) toll–free at 1–877–487–2778 (TDD: 1–888–874–7793)
or by email at NPIC@state.gov. Customer Service Representatives are available M–F 6AM–12 Midnight Eastern
Time (excluding federal holidays). Automated information is available 24/7.
CAN I USE THIS FORM?
Complete this checklist to determine your eligibility to use this form.
I can submit my most recent U.S. passport book and/or U.S. passport
card with this application.
I was at least 16 years old when my most recent U.S. passport book
and/or U.S. passport card was issued.
I was issued my most recent U.S. passport book and/or U.S. passport
card less than 15 years ago.
I use the same name as on my most recent U.S. passport book and/or
U.S. passport card.
— OR —
I have had my name changed by marriage or court order and can
submit proper documentation to reflect my name change.