U.S. Department of State
APPLICATION FOR A U.S. PASSPORT BY MAIL
CAREFULLY FOLLOW THE INSTRUCTIONS ON THE REVERSE OF THIS PAGE
INCOMPLETE OR UNACCEPTABLE APPLICATIONS WILL DELAY THE ISSUANCE OF YOUR PASSPORT.
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 e-mail at NPIC@state.gov. Customer Service
Representatives are available M-F 8AM-8PM EST (excluding federal holidays). Automated
information is available 24/7.
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PLEASE DETACH AND RETAIN THIS INSTRUCTION SHEET
FOR YOUR RECORDS.
Date of Application:
CAN I USE THIS FORM?
Complete this checklist to determine your eligibility to use this form.
1. I can submit my most recent U.S. passport.
2. I was at least 16 years old when my most recent U.S. passport was issued.
3. I was issued my most recent U.S. passport less than 15 years ago.
4. I use the same name as on my most recent U.S. passport.
-- OR --
I have had my name changed by marriage or court order and can submit
proper documentation to reflect my name change.
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 a passport agent,
postal clerk or clerk of court authorized to accept passport applications.
DELIVERY - Other Than U.S. Postal Service
MAIL THIS FORM TO:
WHAT DO I NEED TO SEND WITH THE APPLICATION FORM?
1. Your most recent U.S. passport
2. A marriage certificate or court order if your name has changed
3. Passport processing fee of $55
4. Two recent, color, identical photographs
For detailed information on the items to be included, see below.
YOUR MOST RECENT U.S. PASSPORT. Issued at age 16 or older in your current name (or see item #2 below) and
issued within the past 15 years. If your