DD FORM 1056, MAY 96
PREVIOUS EDITION MAY BE USED.
This form must be typed. See DoD 1000.21-R for form completion instructions.
AUTHORIZATION TO APPLY FOR A "NO-FEE"
PASSPORT AND/OR REQUEST FOR VISA
1. DATE PASSPORT OR VISA
REQUIRED BY APPLICANT
2. MAJOR SERVICE COMPONENT
3. APPLICANT'S LAST NAME - FIRST NAME - MIDDLE NAME 4. APPLICANT'S DATE OF
BIRTH
5. APPLICANT'S PLACE OF BIRTH
6. SPONSOR'S LAST NAME - FIRST NAME - MIDDLE NAME
(If same as Item 3, X block)
7. SPONSOR'S MILITARY
RANK/CIVILIAN GRADE
8. SPONSOR'S SSN
9.a. APPLICANT'S CURRENT HOME ADDRESS (Include ZIP Code) b. HOME TELEPHONE NUMBER (Include area code)
c. OFFICE TELEPHONE NUMBER (Include area code/DSN)
10.a. INTERIM ADDRESS WHERE APPLICANT MAY BE CONTACTED
AFTER DEPARTING LOCATION INDICATED IN ITEM 9
(Include ZIP Code)
b. NAME OF PERSON WITH WHOM RESIDING
c. TELEPHONE (Incl. area code) d. AGENT ID CODE (If applicable)
11. DESTINATION (Country or
Countries)
12. SPECIAL ASSIGNMENT
REQUIRING PASSPORT*
(See Note)
*NOTE: If assignment is to Attache; MAAG; JUSMMAT; Security Assistance Liaison Office (SALO); OSP or other Special Advisory Group, e.g.,
CENTO; or any particular assignment that will govern type and need for a passport, enter such information. If not, enter "Not Applicable."
13. PASSPORT WILL BE FORWARDED TO: (Include complete mailing
address, building number, room number, ZIP Code, and telephone
number/DSN)
14. ESTIMATED DATE OF
DEPARTURE (From country in
which applicant is currently
residing)
15. PROPOSED LENGTH OF
STAY
16. AUTHORIZING OFFICIAL
a. NAME (Last, First, Middle Initial)
b. GRADE c. TITLE
d. COMPLETE MAILING ADDRESS (Include ZIP Code)
e. TELEPHONE NUMBER (Include area code/DSN)
f. SIGNATURE OF AUTHORIZING OFFICIAL g. DATE
17. ADDITIONAL INFORMATION (Attach continuation sheets if
necessary)
FOR USE BY ISSUING OR RECEIVING AGENT (Suspense Control)
18. DATE APPLIED FOR PASSPORT 19. PLACE APPLIED FOR PASSPORT 20. NAME OF COURT OR PASSPORT AGENT
21. DATE PASSPORT RECEIVED
FROM DEPARTMENT OF STATE
22. PASSPORT NUMBER 23. DATE OF PASSPORT
ISSUE
24. PASSPORT
EXPIRATION DATE
25. DOCUMENT(S) INCLUDED WITH
PASSPORT
26. COUNTRY AND DATE VISA REQUESTED 27. DATE PASSPORT
RECEIVED WITH VISA
28. DATE PASSPORT
MAILED
PRIVACY ACT STATEMENT
AUTHORITY: Sections 3012, 8012, 5031, Title 10 USC; 22 CFR 51.63; EO 9397.
PRINCIPAL PURPOSE: To provide authority for issue of "No-Fee" passport and/or request for a visa which is an endorsement stamped or
written on a passport, showing that it has been examined by the proper officials of a country and granting entry into that country. The Social
Security Number is required to verify and/or identify the applicant.
ROUTINE USES: Information is used in conjunction with application for passport/visa and foreign travel. Information may be released to other
DoD agencies, various activities within the Department of State, foreign embassies and consulates.
DISCLOSURE: Voluntary; however, if applicant does not provide information, a "No-Fee" passport cannot be authorized.
