Instruction	Page	1	of	3
NOTICE	TO	APPLICANTS	RESIDING	ABROAD
United States citizens residing abroad CANNOT submit the form to the domestic addresses listed above. Such
applicants should contact the nearest U.S. embassy or consulate for procedures to be followed when applying
PLEASE DETACH AND RETAIN THIS INSTRUCTION SHEET FOR YOUR RECORDS.
Date	of	Application:
FOR	INFORMATION,	QUESTIONS,	AND	INQUIRIES:
Please visit our website at travel.state.gov.	In addition, you may 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.
HOW	DO	I	APPLY	FOR	ADDITIONAL	VISA	PAGES?
1.				Complete, sign and date this form.
2. send this form with your valid u.s. passport book
IS	THERE	A	FEE	ASSOCIATED	WITH	THIS	FORM	AND
HOW	WILL	MY	NEW	PASSPORT	BOOK	BE	MAILED	BACK	TO	ME?
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.
•	 There is no fee associated with the use of this form unless expedited service is requested (see below). Your U.S. passport book will be
returned to you by priority mail.
•	 OVERNIGHT DELIVERY SERVICE: If you desire overnight delivery for the return of your passport, please include the appropriat