Fillable Application For A U.s. Passport (Page 2 of 6) in pdf

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.

PROOF OF U.S. CITIZENSHIP

a. APPLICANTS BORN IN THE UNITED STATES: Submit a previous U.S. passport or certified birth certificate. A birth certificate must include your full name,

the full name of your parent(s), date and place of birth, sex, date the birth record was filed, and the seal or other certification of the official custodian of such

records.

If the birth certificate was filed more than 1 year after the birth: It must be supported by evidence described in the next paragraph.

If no birth record exists: Submit a registrar’s notice to that effect. Also submit a combination of the following: an early baptismal or circumcision certificate,

hospital birth record, early census, school, or family Bible records, or newspapers or insurance files. Notarized affidavits of persons having knowledge

of your birth may be submitted in addition to at least one record listed above. Evidence should include your given name and surname, date and place

of birth, and the seal or other certification of the office (if customary) and the signature of the issuing official. Visit travel.state.gov for details.

b. APPLICANTS BORN OUTSIDE THE UNITED STATES: Submit a previous U.S. passport, Certificate of Naturalization, Certificate of Citizenship, Report of Birth

Abroad, or evidence described below.

If You Claim Citizenship Through Naturalization Of Parent(s): Submit the Certificate(s) of Naturalization of your parent(s), your foreign birth certificate,

and proof of your admission to the United States for permanent residence.

If You Claim Citizenship Through Birth Abroad To One U.S. Citizen Parent: Submit a Consular Report of Birth (Form FS–240), Certification of Birth (Form

DS–1350 or FS–545), or your foreign birth certificate, proof of citizenship of your parent, your parents’ marriage certificate, and an affidavit showing

all of your U.S. citizen parent’s periods and places of residence/physical presence in the United States and abroad before your birth.

If You Claim Citizenship Through Birth Abroad To Two U.S. Citizen Parents: Submit a Consular Report of Birth (Form FS–240), Certification of Birth (Form

DS–1350 or FS–545), or your foreign birth certificate, parents’ marriage certificate, proof of your parents’ citizenship, and an affidavit showing all of

your U.S. citizen parents’ periods and places of residence/physical presence in the United States and abroad before your birth.

If You Claim Citizenship Through Adoption by a U.S. Citizen Parent(s): Submit evidence of your permanent residence status, full and final adoption, and

your U.S. citizen parent(s) evidence of legal and physical custody. (Please note: Acquisition of U.S. citizenship for persons born abroad and adopted

only applies if the applicant was born on or after 02/27/1983.)

c. ADDITIONAL EVIDENCE: When necessary, we may ask you to provide additional evidence to establish your claim to U.S. citizenship.

2. PROOF OF IDENTITY

You must establish your identity to the satisfaction of the acceptance agent.

You may submit items such as the following containing your signature AND physical description or photograph that is a good likeness of you: previous or cur-

rent U.S. passport book; previous or current U.S. passport card; driver’s license (not temporary or learner’s license); Certificate of Naturalization, Certificate of

Citizenship; military identification; or federal, state, or municipal government employee identification card or pass. Temporary or altered documents are not

acceptable. When necessary, we may ask you to provide additional evidence to establish your identity.

IF YOU CANNOT PROVIDE DOCUMENTARY EVIDENCE OF IDENTITY as stated above, you must appear with an IDENTIFYING WITNESS who is a U.S. citizen,

non–citizen U.S. national, or permanent resident alien who has known you for at least 2 years. Your witness must prove his or her identity and complete and

sign an Affidavit of Identifying Witness (Form DS–71) before the acceptance agent. You must also submit some identification of your own.

3. TWO RECENT COLOR PHOTOGRAPHS

Submit two identical color photographs of you alone, sufficiently recent to be a good likeness of you (taken within the last six months), and 2x2 inches in size.

The image size measured from the bottom of your chin to the top of your head (including hair) should not be less than 1 inch and not more than 1–3/8 inches.

The photographs must be color, clear, with a full front view of your face, and printed on thin paper with plain light (white or off–white) background. The pho-

tographs must be taken in normal street attire, without a hat, head covering, or dark glasses unless a signed statement is submitted by the applicant verifying

the item is worn daily for religious purposes or a signed doctor’s statement is submitted verifying the item is used daily for medical purposes. Photographs

retouched so that your appearance is changed are unacceptable. Snapshots, most vending machine prints, and magazine or full–length photographs are unac-

ceptable. Digitized photos must meet the previously stated qualifications and will be accepted for use at the discretion of Passport Services. (Visit our website

for details.)

4. FEES

a. If you are 16 years of age or older: Your passport will be valid for 10 years from the date of issue except where limited by the Secretary of State to a

shorter period. (See information below about the additional cost for expedited service.)

b. If you are under 16 years of age: Your passport will be valid for 5 years from the date of issue except where limited by the Secretary of State to a shorter

period. (See information below about the additional cost for expedited service.)

BY LAW, THE PASSPORT FEES ARE NON–REFUNDABLE. PLEASE VISIT OUR WEBSITE AT TRAVEL.STATE.GOV FOR CURRENT FEES.

• The passport processing, execution, and security fees may be paid in any of the following forms: Checks (personal, certified, traveler’s); major

credit card (Visa, Master Card, American Express, and Discover); bank draft or cashier’s check; money order (U.S. Postal, international, currency exchange),

or if abroad, the foreign currency equivalent, or a check drawn on a U.S. bank. All fees should be payable to the “U.S. Department of State” or if abroad, the

appropriate U.S. embassy or U.S. consulate. When applying at a designated acceptance facility, the execution fee will be paid separately and should be made

payable to the acceptance facility. NOTE: Some designated acceptance facilities do not accept credit cards as a form of payment.

• For faster processing, you may request expedited service. Please include the expedite fee in your payment. Our website contains updated information

regarding fees and processing times for expedited service. Expedited service is available only in the United States.

• If you desire OVERNIGHT DELIVERY SERVICE for the return of your passport, please include the appropriate fee with your payment.

• An additional fee will be charged when, upon your request, the U.S. Department of State verifies issuance of a previous U.S. passport or Consular Report of Birth

Abroad because you are unable to submit evidence of U.S. citizenship.

• For applicants with U.S. Government or military authorization for no–fee passports, no fees are charged except the execution fee when applying at

a designated acceptance facility.

• If you choose to provide your e–mail address in Item #8 on this application, Passport Services will only use that information to contact you in the event there

is a problem with your application or if you need to provide additional information to us.

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Instruction Page 2 of 4