Form DS-11 - Free Download
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Form DS-11
Form DS-11
See page 2 of the instructions for detailed information on the completion and submission of this form.
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. To determine your eligibility, please visit travel.state.gov
, or contact NPIC. 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.
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 U.S. law including 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 herein or of the passport regulations is punishable by fine and/or
imprisonment under 18 USC 1544. All statements and documents are subject to verification.
AS DIRECTED BY PUBLIC LAW 106-113 AND 22 CFR 51.28:
To submit an application for a child under age 16 both parents or the 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.
IF ONLY ONE PARENT APPEARS, YOU MUST ALSO SUBMIT ONE OF THE FOLLOWING:
- Second parent's notarized written statement or DS-3053 (including the child's full name and date of birth) consenting to the passport issuance for the child.
Statement can not
be more than 3 months old and must come with a photocopy of the front and back side of the second parent's identification, OR
- Second parent’s death certificate if second parent is deceased, OR
- Primary evidence of sole authority to apply, OR
- A written statement or DS-3053 (made under penalty of perjury) explaining in detail the second parent's unavailability.
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.
SPECIAL REQUIREMENTS FOR CHILDREN
FAILURE TO PROVIDE INFORMATION REQUESTED ON THIS FORM, INCLUDING YOUR SOCIAL SECURITY NUMBER,
MAY RESULT IN SIGNIFICANT PROCESSING DELAYS AND/OR THE DENIAL OF YOUR APPLICATION.
FOR INFORMATION, QUESTIONS, AND INQUIRIES:
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 THE TRADITIONAL 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 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 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 NPIC@state.gov
. Customer
Service Representatives are available Monday-Friday 8:00a.m.-10:00p.m. Eastern Time (excluding federal
holidays.) Automated information is available 24/7.
APPLICATION FOR A U.S. PASSPORT
PLEASE DETACH AND RETAIN THIS INSTRUCTION SHEET FOR YOUR RECORDS
I applied:
DS-11 12-2010
Place:
Date:
Instruction Page 1 of 4
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 (You must present your original identification AND submit a photocopy of the front and back side with your passport application.)
3. RECENT COLOR PHOTOGRAPH (Photograph must meet passport requirements – full front view of the face and 2x2 inches in size.)
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 accepting applications; a designated municipal or county official; a designated postal employee at an authorized post office; an agent
at a passport agency (by appointment only); or a U.S. consulate official at a U.S. embassy or consulate, if abroad. To find your nearest acceptance facility,
visit travel.state.gov
or contact the National Passport Information Center.
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