U.S. Passport Renewal Application for Eligible Individuals

I can submit my most recent U.S. passport book and/or U.S. passport
card with this application.
I was at least 16 years old when my most recent U.S. passport book
and/or passport card was issued.
I w as issued my most recent U.S. passport book and/or passport
card less than 15 years ago.
My most recent U.S. passport book and/or U.S. passport card that
I am renewing has not been lost, stolen, mutilated, or damaged.
My U.S. passport has not been limited from the normal ten year
validity period due to passport damage/mutilation, multiple passport
thefts/losses, or non-compliance with 22 C.F.R. 51.41. (Please
refer to the back pages of your U.S. passport book for endorsement
information.)
I use the same name as on my recent U.S. passport book and/or
U.S. passport card.
I have had my name changed by marriage or court order and can
submit proper documentation to reflect my name change.
Yes
No
U.S. PASSPORT RENEWAL APPLICATION FOR ELIGIBLE INDIVIDUALS
PLEASE DETACH AND RE TAIN THIS INSTRUCT ION SHEET FOR YOUR RECORDS
CAN I USE THIS FORM?
Complete the checklist to determine your eligibility to use this form
Yes No
If you answered NO to any of the statements above,
STOP - You cannot use this form!
You must apply on application form DS-11 by making a personal appearance before an acceptance agent
authorized to accept passport applications. Visit travel.state.gov
to find your nearest acceptance facility.
Yes
No
Yes No
Yes
No
--OR--
Date of Application:_____________________
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 U.S. PASSPORT BOOK OR PASSPORT CARD. THE PASSPORT CARD IS A U.S. PASSPORT ISSUED IN CARD
FORMAT. LIKE THE TRADITIONAL PASSPORT BOOK, IT REFLECTS THE BEARER'S ORIGIN, IDENTITY, AND NATIO NALITY AND IS SUBJECT TO
EXISTING PASSPORT LAWS AND REGULATIONS. UNLIKE THE PASSPORT BOOK, THE PASSPORT CARD IS VALID ONLY FOR ENTRY TO THE
UNITED STATES AT LAND BORDER CROSSINGS AND SEA PORTS OF ENTRY WHEN TRAVELING FROM CANADA, MEXICO, THE CARIBBEAN,
AND BERMUDA. THE U.S. PASSPORT CARD IS NOT VALID FOR INTERNATIONAL AIR TRAVEL.
PLEASE NOTE
: YOUR NEW PASSPORT WILL HAVE A DIFFERENT PASSPORT NUMBER THAN YOUR PREVIOUS PASSPORT.
FAILURE TO PROVIDE INFORMATIO N REQUESTED ON THI S FORM, INCLUDING YOUR SOCIAL SECURITY NUMBER,
MAY RESULT IN SIGNIFICANT PROCESSING DELAYS AND/OR THE DENIAL OF YOUR APPLICATION.
NOTICE TO APPLICANTS RESIDING ABROAD
United States citizens residing abroad CANNOT submit this form to the domestic address listed on the Instruction Page 2. Such applicants should contact the
nearest U.S. Embassy or Consulate for procedures to be followed when applying overseas.
DS-82 08-2013 Inst ruct io n Page 1 of 4
WARNING: False statements made knowingly a nd willfully in passport applications, including affidavits or other documents submitted to support
this application, are punishable by fine and/or imprisonment under U.S. law , inc luding the provisions of 18 U.S.C. 1001, 18 U.S.C. 1542, and/or 18
U.S.C. 1621. Alteration or mutilation of a passport issued pursuant to this application is punishable by fine and/or imprisonment under the
provisions of 18 U.S.C. 1543. The use of a passport in violation of the restrictions contained therein or of the pas sport regulations is punishable
by fine and/or imprisonment under 18 U.S.C. 1544. All statements and documents are subject to verification.
See page 2 of the instructions for detailed information on the completion and submission of this form.
INFORMATION, QUESTIONS, AND INQUIRIES
Please visit our website at travel.state.gov. In addition, you may contact the National Passport Information
Center (NPIC) toll-free at 1-877-487-2778 (TDD: 1-888-874-7793) or by email at [email protected]ov
. Customer
Service Representatives are available Monday-Friday 8:00a.m.-10:00p.m. Eastern Time (excluding federal
holidays.) Automated information is available 24 hours a day, 7 days a week.
Yes
No
Page 1/6
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