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U.S. Department of State APPLICATION FOR A U.S. PASSPORT

PLEASE DETACH AND RETAIN THIS INSTRUCTION SHEET FOR YOUR RECORDS.
I applied: Place: Date:
FOR INFORMATION, QUESTIONS, AND INQUIRIES: Please visit our website at travel.state.gov. In addition, you can contact the National Passport Information Center (NPIC) toll–free at 1–877–487–2778 (TDD: 1–888– 874–7793) or by e–mail atNPIC@state.gov. Customer Service Representatives are available M–F, 6AM–12 Midnight Eastern Time (excluding federal holidays). Automated information is available 24/7.
U.S. PASSPORTS, EITHER IN BOOK OR CARD FORMAT, ARE ISSUED ONLY TO U.S. CITIZENS OR NON–CITIZEN NATIONALS. EACH PERSON MUST OBTAIN HIS OR HER OWN PASSPORT BOOK OR PASSPORT CARD. THE PASSPORT CARD IS A U.S. PASSPORT ISSUED IN CARD FORMAT. LIKE THETRADITIONAL PASSPORT BOOK, IT REFLECTS THE BEARER’S ORIGIN, IDENTITY, AND NATIONALITY AND IS SUBJECT TO EXISTING PASSPORT LAWS AND REGULATIONS. UNLIKE THE PASSPORT BOOK, THE PASSPORT CARD IS VALID ONLY FOR INTERNATIONAL TRAVEL BY LAND OR SEA BETWEEN THE UNITED STATES, CANADA, MEXICO, THE CARIBBEAN AND BERMUDA. IT IS NOT GLOBALLY INTEROPERABLE AND IS NOT VALID FOR TRAVEL BY AIR TO OR FROM ANYFOREIGN DESTINATION.

APPLICANTS WHO HAVE HAD A PREVIOUS U.S. PASSPORT BOOK AND/OR U.S. PASSPORT CARD
If your most recent passport book and/or passport card was issued less than 15 years ago and you were over 16 years old at the time of issuance, you may be eligible to use Form DS–82 (mail–in or electronic application). Please inquire about eligibility when you apply, visit our website, or contactNPIC. Address any requests for the addition of visa pages to a Passport Agency or a U.S. consulate or embassy abroad. In advance of your departure, check for any visa requirements with consular officials of the countries you will be visiting.
SPECIAL REQUIREMENTS FOR CHILDREN • AS DIRECTED BY PUBLIC LAW 106–113 AND 22 CFR 51.28: To submit an application for a child under age 16 both parents orthe child’s legal guardian(s) must appear and present the following: • • • • • • • Evidence of the child’s U.S. citizenship, Evidence of the child’s relationship to parents/guardian(s), AND Parental/guardian identification. Second parent’s notarized written statement consenting to passport issuance for the child, Primary evidence of sole authority to apply, OR A written statement (made under penaltyof perjury) explaining the second parent’s unavailability.

IF ONLY ONE PARENT APPEARS YOU MUST ALSO SUBMIT ONE OF THE FOLLOWING:

AS DIRECTED BY REGULATION 22 CFR 51.21 and 51.28: Each minor child applying for a passport book and/or passport card must appear in person.

WHAT TO SUBMIT WITH THIS FORM:
1. PROOF OF U.S. CITIZENSHIP (Evidence of U.S. citizenship that is not damaged, altered,or forged will be returned to you.) 2. PROOF OF IDENTITY 3. TWO RECENT COLOR PHOTOGRAPHS, AND 4. FEES (Please visit our website at travel.state.gov for current fees.)

WHERE TO SUBMIT THIS FORM:
Please complete and submit this application in person to one of the following acceptance agents: a clerk of a Federal or State court of record or a judge or clerk of a probate court acceptingapplications; a designated municipal or county official; a designated postal employee at an authorized post office; or an agent at a Passport Agency (by appointment only) in Boston, Chicago, Aurora CO, Honolulu, Houston, Los Angeles, Miami, New Orleans, New York, Norwalk CT, Philadelphia, San Francisco, Seattle, or Washington DC; or a U.S. consular official at a U.S. embassy or consulate, if abroad. To findyour nearest acceptance facility, visit our website or contact the National Passport Information Center.

See Instruction Page 2 for detailed information on the completion and submission of this form.
DS–11 02-2008 Instruction Page 1 of 4

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