Fsm Passport Application Form - Federated States Of Micronesia (Page 2 of 3) in pdf

INSTRUCTIONS

This Passport Application Form must be filled out completely, signed and notarize prior to submission

to the FSM Passport Office. Please print all information in Block Letters.

For new applicant or renewal of expired passport the following documents are required.

New Passport (New Applicant) – The Passport Application Form must be Notarized

o Court Registered Birth Certificate

o Two Identical Passport Photos of the applicant (size: 1

x 1 ¾ passport photo)

3/16

o Court Registered Marriage Certificate for maiden name change

o In cases of unavailability of records of Birth Certificate, a court registered Baptismal Certificate

can be submitted with your application form.

o If basis of FSM Citizen is Naturalization provide copy of Naturalization Certificate

Passport Renewal – The Passport Application Form must be Notarized

o The expired passport must be submitted with your Application Form

o Two Identical passport photos of the applicant (size: 1

x 1 ¾ passport photo)

3/16

o Payment of passport renewal fee payable to the FSM National Treasury in the amount indicated

above.

Passport Replacement – The Passport Application Form must be Notarized

a) A passport that is lost, stolen, damaged or mutilated may be replaced. Application for a

replacement shall be made by submitting an Application Form, the passport itself if available, a

sworn affidavit detailing the circumstances surrounding the loss, theft, damage or mutilation of

the passport; replacement fee in money order or cashiers check payable to the FSM National

Treasury, and two identical passport photos of the applicant. The Replacement fee for lost,

stolen, damage and mutilated shall be $75.00

b) A passport that has no remaining blank visa pages before the date of expiration may be replaced.

Application for a replacement shall be made by submitting an Application Form, the passport, a

fee of $25.00 in money order or cashiers check payable to FSM National Treasury and two

identical passport photos

a) A passport issued to an infant under 12 months may be replaced. Application for a replacement

shall be made by submitting an Application Form, the passport itself, two identical passport

photos and a passport fee of $50.00

Applicants who are under the age of 14 but are capable of signing the application should sign the

application. However, a signature of a parent or guardian shall also be required for applicants

under the age of 14. Applicants who are 14 or older but are unable to sign the application due to

incapacity or disability shall, in their own handwriting, place an “X” in the signature box. In the

event an applicant’s incapacity or disability prevents the applicant from placing an “X” in the

signature box, the signature box shall remain vacant and the application shall be accompanied by

a written statement of a close relative, legal guardian, or medical doctor attesting to the

applicant’s inability to sign the application. In such circumstances, a parent, legal guardian, or

other close relative shall sign the application in the space provided for parents and guardians

signature on the application form.

Applicant’s Contacts – Email Address or Phone Number

a) Please ensure that you complete the application form with your Email Address (if applicable) or

Phone Number so we can contact you as soon as possible if we found your application to be

incomplete.

Fsm Passport Application Form - Federated States Of Micronesia Page 2

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