U.S. Passport Re-Application Form

U.S. Department of State
U.S. PASSPORT RE-APPLICATION FORM
DS-5504
09-2005
Instruction Page 1 of 4
PLEASE DETACH AND RETAIN THIS INSTRUCTION SHEET
FOR YOUR RECORDS.
Date of Application:
CAREFULLY FOLLOW THE INSTRUCTIONS ON THE REVERSE OF THIS PAGE.
READ ALL WARNINGS, NOTICES AND STATEMENTS ON INSTRUCTION PAGES 3 AND 4.
INCOMPLETE OR UNACCEPTABLE APPLICATIONS WILL DELAY THE ISSUANCE OF YOUR PASSPORT.
CAN I USE THIS FORM?
Complete this checklist to determine your eligibility to use this form.
1. My most recent U.S. passport was issued less than one year ago.
2. I can submit my most recent U.S. passport.
3. I have had a change in my identifying information;
My identifying information was printed incorrectly;
-- OR --
My most recent U.S. passport was issued outside the United States and
limited in validity for one year or less, and/or issued abroad.
Yes
No
Yes
No
If you answered NO to any of the three statements above,
STOP - You cannot use this form!!!
You must apply on application form DS-11 or DS-82 depending on your circumstances. Please refer to those forms, visit
our website, or contact the National Passport Information Center for further information.
Yes
No
Please visit our website at www.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 Monday -Friday,
8AM-8PM EST (excluding Federal holidays). Automated information is available 24/7.
FOR INFORMATION, QUESTIONS, AND INQUIRES:
Page 1/6
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U.S. Passport Re-Application Form PDF

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