Personal Passport Application Form

PERSONAL PASSPORT APPLICATION FORM

This form is a formal application for an ordinary passport. Complete all applicable sections accurately. Providing false or misleading information may subject the applicant to criminal penalties. All fields marked as required must be completed.

Application Type

Application Type: New passport Renewal Replacement (lost/stolen) Child under 16

1. Applicant Information

Date of birth:    Place of birth (city, state/country):

Nationality:    Gender: Male Female Other

2. Identification and Citizenship Evidence

Provide the documents attached with this application (check all that apply):

Birth certificate (original or certified copy) Certificate of naturalization Government-issued photo ID (driver's license) Name change documentation (marriage certificate, court order) Previous passport (if available) Number of passport photos attached:

3. Current or Previous Passport (if applicable)

Passport number:    Issue date:    Expiration date:    Place of issue:

4. Travel Plans and Emergency Contact

Intended date of travel:

5. Parental / Guardian Information (if applicant is under 16)

Is the applicant under age 16? Yes No

By checking the box below, the applicant affirms that parental/guardian consent has been obtained and required parental documentation is attached: Parental/guardian consent and identification attached

6. Declarations, Certification and Privacy Notice

I certify under penalty of law that the information contained in this application and any accompanying documents is true and correct to the best of my knowledge. I authorize the use and disclosure of personal information contained herein for the purposes of verifying identity, determining eligibility for passport issuance, and law enforcement or national security purposes where authorized by law. I understand that knowingly making a false statement in this application may subject me to criminal prosecution.

By signing below, applicant acknowledges that the signature attests to the accuracy of information provided and authorizes processing of this application.

7. Applicant Attestation for Lost/Stolen Passport (If applicable)

If this application is for replacement of a passport reported lost or stolen, provide a concise statement of circumstances and any police report number if filed.

8. Applicant Acknowledgement

By submitting this application, I acknowledge that I have read and understand the certification above and that I am the individual named in this application or am authorized to act on the applicant's behalf. I acknowledge that processing times vary and that it is my responsibility to provide all required supporting documentation.

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