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APPLICATION FOR A U.S. PASSPORT BY MAIL
PLEASE DETACH AND RETAIN THIS INSTRUCTION SHEET
FOR YOUR RECORDS.
Date of Application:
See Instruction Page 2 for Detailed Information
on the Completion and Submission of this Form.
INCOMPLETE OR UNACCEPTABLE APPLICATIONS WILL DELAY THE ISSUANCE OF YOUR PASSPORT.
If you answered NO to any of the four 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 nd your nearest acceptance facility.
DS–82 Instruction Page 1 of 4
02-2008
NOTICE TO APPLICANTS RESIDING ABROAD
United States citizens residing abroad CANNOT submit this form to the Passport Facility listed on Instruction Page 2. Such
applicants should contact the nearest United States embassy or consulate for procedures to be followed when applying
overseas.
FOR INFORMATION, QUESTIONS, AND INQUIRIES: Please visit our website at 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 email at NPIC@state.gov. Customer Service Representatives are available M–F 6AM–12 Midnight Eastern
Time (excluding federal holidays). Automated information is available 24/7.
CAN I USE THIS FORM?
Complete this checklist to determine your eligibility to use this form.
I can submit my most recent U.S. passport book and/or U.S. passport
card with this application.
Yes No
I was at least 16 years old when my most recent U.S. passport book
and/or U.S. passport card was issued.
Yes
No
I was issued my most recent U.S. passport book and/or U.S. passport
card less than 15 years ago.
Yes No
I use the same name as on my most recent U.S. passport book and/or
U.S. passport card.
— OR —
I have had my name changed by marriage or court order and can
submit proper documentation to reect my name change.
Yes No
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
INTERNATIONAL TRAVEL BY LAND OR SEA BETWEEN THE UNITED STATES, CANADA, MEXICO, THE CARIBBEAN AND BERMUDA. IT IS NOT
GLOBALLY INTEROPERABLE AND IS NOT VALID FOR TRAVEL BY AIR TO OR FROM ANY FOREIGN DESTINATION.
WHAT DO I SEND WITH THIS APPLICATION FORM?
- Your most recent U.S. passport book and/or U.S. passport card
- A marriage certicate or court order if your name has changed
- Fees
- Two recent, color photographs
(Please visit our website at travel.state.gov for detailed information regarding current fees.)
See below for more detailed information.
DS–82 Instruction Page 2 of 4
02-2008
1. YOUR MOST RECENT U.S. PASSPORT (BOOK AND/OR CARD FORMAT). Submit your most recently issued passport book and/or passport card.
When submitting a passport book and/or passport card with this form, please verify that the document was issued at age 16 or older in your current
name (or see item #2 below) and issued within the past 15 years. If your U.S. passport is damaged, you must apply on the DS–11 Application form as
specied below.
2. A MARRIAGE CERTIFICATE OR COURT ORDER.
If the name you are currently using differs from the name on your most recent passport, you
must submit a marriage certicate or court order showing the change of name. The name change document may be a certied copy or a complete and
unaltered photocopy showing a seal and ofciate/judge signature. All documents will be returned to you by mail. If you are unable to document your
name change in this manner, you must apply on the DS–11 Application form by making a personal appearance at (1) a passport agency; (2) any Federal
or State court of record or any probate court accepting passport applications; or (3) a Post Ofce which has been selected to accept passport applica-
tions.
3. THE CURRENT PASSPORT FEE.
Enclose the fee in the form of a personal check or money order. MAKE CHECKS PAYABLE TO “DEPARTMENT OF
STATE.” THE FULL NAME AND DATE OF BIRTH OF THE APPLICANT MUST BE TYPED OR PRINTED ON THE FRONT OF THE CHECK. DO
NOT SEND CASH. Passport Services cannot be responsible for cash sent through the mail. By law, the fees are non–refundable.
OVERNIGHT DELIVERY SERVICE: If you desire overnight delivery service for the return of your passport, please include the appropriate fee with your
payment.
FASTER PROCESSING: For an additional fee, you may request expedited service. Please include this fee in your payment and submit the application to
the appropriate address. Please write “Expedite” on the outer envelope when mailing. Also, TO ENSURE MINIMAL PROCESSING TIME
for expedited applications, Passport Services recommends using overnight delivery when submitting the application AND including
the appropriate postage fee for return overnight delivery for the completed passport book or passport card. Expedited service is available
only in the United States. Please visit our website for updated information regarding fees and service times.
4. TWO RECENT, COLOR PHOTOGRAPHS
. Submit two color photographs of you alone, sufciently recent to be a good likeness of you (normally taken
within the last six months), and 2x2 inches in size. The image size measured from the bottom of your chin to the top of your head (including hair) should
not be less than 1 inch and not more than 1 3/8 inches. The photographs must be color, clear, with a full front view of your face, and printed on thin
paper with plain light (white or off–white) background. Photographs must be taken in normal street attire, without a hat, head covering, or dark glasses
unless a signed statement is submitted by the applicant verifying the item is worn daily for religious purposes or a signed doctor’s statement is submitted
verifying the item is used daily for medical purposes. Photographs retouched so that your appearance is changed are unacceptable. Snapshots, most
vending machine prints, and magazine or full–length photographs are unacceptable. Digitized photos must meet the previously stated qualications and
will be accepted for use at the discretion of Passport Services. Visit our website for details and information regarding afxing the photograph to the
application.
NOTE: If you choose to provide your e–mail address in Item #8 on this application, Passport Services will only use that information to
contact you in the event there is a problem with your application or if you need to provide additional information to us.
WHERE DO I MAIL THIS APPLICATION?
WARNING: False statements made knowingly and willfully in passport applications, including afdavits or other documents submitted
to support this application, are punishable by ne and/or imprisonment under 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 ne and/or imprisonment under
the provisions of 18 USC 1543. The use of a passport in violation of the restrictions contained therein or of the passport regulations is
punishable by ne and/or imprisonment under 18 USC 1544. All statements and documents are subject to verication.
MAIL THIS FORM TO:
National Passport Processing Center
Post Ofce Box 90155
Philadelphia, PA 19190-0155
MAIL THIS FORM TO:
National Passport Processing Center
Post Ofce Box 90955
Philadelphia, PA 19190-0955
ROUTINE SERVICE
EXPEDITED SERVICE (Additional Fee)
DS–82 Instruction Page 3 of 4
02-2008
Section 6039E of the Internal Revenue Code (26 U.S.C. 6039E) requires you to provide your Social Security Number (SSN), if you have one,
when you apply for a U.S. passport or renewal of a U.S. passport. If you have not been issued a SSN, enter zeros in box #5 of this form. If
you are residing abroad, you must also provide the name of the foreign country in which you are residing. The Department of State must
provide your SSN and foreign residence information to the Department of Treasury. If you fail to provide the information, you are subject
to a $500 penalty enforced by the IRS. All questions on this matter should be directed to the nearest IRS ofce.
FEDERAL TAX LAW
NOTICE TO CUSTOMERS MAKING PAYMENT BY CHECK
If you send us a check, it will be converted into an electronic funds transfer (EFT). This means we will copy your check and use the account
information on it to electronically debit your account for the amount of the check. The debit from your account will usually occur within 24
hours, and will be shown on your regular account statement.
You will not receive your original check back. We will destroy your original check, but we will keep the copy of it. If the EFT cannot be
processed for technical reasons, you authorize us to process the copy in place of your original check. If the EFT cannot be completed be-
cause of insufcient funds, we may try to make the transfer up to two times and we will charge you a one–time fee of $25, which we will
also collect by EFT.
REMITTANCE OF FEES
31 U.S.C. 7701 requires persons “doing business” with a federal agency to provide their Social Security Numbers to that agency. Because
the Department of State collects fees for the provision of passport services to you, you are considered a person “doing business” with the
Department. Passport service fees are established by law and regulation (see 22 U.S.C. 214, 22 CFR 22.1, and 22 CFR 51.50–56) and are
collected at the time you apply for the passport service. If the Department fails to receive full payment of the applicable fees, because, for
example, your check is returned for any reason or you dispute a passport fee charge to your credit card, the Department of State will take
action to collect the delinquent fees from you under 22 CFR Part 34 and the Federal Claims Collection Standards (see 31 CFR Parts 900–904).
In accordance with the Debt Collection Improvement Act (Pub.L. 104–134), if the fees remain unpaid after 180 days and no repayment ar-
rangements have been made, the Department will refer the debt to the Department of Treasury for collection. Debt collection procedures
used by Treasury may include referral of the debt to private collection agencies, reporting of the debt to credit bureaus, garnishment of private
wages and administrative offset of the debt by reducing or withholding eligible Federal payments (e.g. tax refunds, social security payments,
federal retirement, etc.) by the amount of your debt, including any interest penalties or other costs incurred. In addition, non–payment of
passport fees may result in the invalidation of your passport. An invalidated passport cannot be used for travel.
IMPORTANT NOTICE TO APPLICANTS WHO HAVE LOST OR HAD A PREVIOUS PASSPORT BOOK
AND/OR PASSPORT CARD STOLEN
A United States citizen may not normally bear more than one valid or potentially valid U.S. passport book or more than one valid or potentially
valid U.S. passport card at a time. Therefore, when a valid or potentially valid U.S. passport book or U.S. passport card cannot be presented
with a new application, it is necessary to submit a Form DS-64, Statement Regarding a Lost or Stolen Passport. Your statement must detail
why the previous U.S. passport book or U.S. passport card cannot be presented.
The information you provide regarding your lost or stolen U.S. passport book or passport card will be placed into our Consular Lost or Stolen
Passport System. This system is designed to prevent the misuse of your lost or stolen U.S. passport book or passport card. Anyone using
the passport book or passport card reported as lost or stolen may be detained upon entry into the United States. Should you locate the
U.S. passport book or passport card reported lost or stolen at a later time, report it as found and submit it for cancellation. It has been
invalidated. You may not use that passport book or passport card for travel.
PROTECT YOURSELF AGAINST IDENTITY THEFT
REPORT YOUR LOST OR STOLEN PASSPORT BOOK OR PASSPORT CARD!
For more information or to report your lost or stolen passport book or passport card by phone, call NPIC or visit our website at
travel.state.gov.
OTHER USES OF SOCIAL SECURITY NUMBERS
In addition to reporting your Social Security Number to Treasury and using it in connection with debt collection, the Department checks Social
Security Numbers against lists of persons ineligible or potentially ineligible to receive a U.S. passport.
You are not required to provide the information requested on this form unless the form displays a currently valid OMB number. We try to
create forms and instructions that can be easily understood. Often this is difcult to do because our citizenship laws are very complex. The
estimated burden time for this information collection is 40 minutes, which includes the time required to search existing data sources, gather
the necessary data, complete and review this form, and provide and submit the form and any additional information required. If you have
comments concerning the accuracy of this time estimate or suggestions for making this form simpler, we would be happy to hear from you.
You can write to us at: U.S. Department of State (A/ISS/DIR) Washington, DC 20520.
PAPERWORK REDUCTION STATEMENT
DS–82 Instruction Page 4 of 4
02-2008
(If any of the below–mentioned acts or conditions have been performed by or apply to the applicant, the portion which applies should be
lined out, and a supplementary explanatory statement under oath (or afrmation) by the applicant should be attached and made a part of
this application.) I have not, since acquiring United States citizenship/nationality, been naturalized as a citizen of a foreign state; taken an
oath or made an afrmation or other formal declaration of allegiance to a foreign state; entered or served in the armed forces of a foreign
state; accepted or performed the duties of any ofce, post, or employment under the government of a foreign state or political subdivision
thereof; made a formal renunciation of nationality either in the United States, or before a diplomatic or consular ofcer of the United States
in a foreign state; or been convicted by a court or court martial of competent jurisdiction of committing any act of treason against, or at-
tempting by force to overthrow, or bearing arms against, the United States, or conspiring to overthrow, put down, or to destroy by force,
the Government of the United States.
ACTS OR CONDITIONS
AUTHORITIES: Collection of the information solicited on this form is authorized by Titles 8, 22, and 26 of the United States Code, whether
or not codied, including specically 22 U.S.C. 211a et seq.; 26 U.S.C. 6039E, Section 236 of the Admiral James W. Nance and Meg Donovan
Foreign Relations Authorization Act, Fiscal Years 2000 and 2001; Executive Order 11295 (August 5, 1966); and 22 CFR parts 50 and 51.
PURPOSE: The primary purpose for soliciting the information is to establish citizenship, identity, and entitlement to issuance of a U.S.
passport.
ROUTINE USES: The information solicited on this form may be made available as a routine use to other government agencies to assist the
U.S. Department of State in adjudicating passport applications and requests for related services, and for law enforcement and administra-
tive purposes. The information may be made available to foreign government agencies to fulll passport control and immigration duties.
The information may also be provided to foreign government agencies, international organizations and, in limited cases, private persons
and organizations to investigate, prosecute, or otherwise address potential violations of law or to further the Secretary’s responsibility for
the protection of U.S. citizens and non–citizen nationals abroad. The information may be made available to private U.S. citizen ‘wardens’
designated by the U.S. embassies and consulates. For a more detailed listing of the routine uses to which this information may be put, see
the Prefatory Statement of Routine Uses and the listing of routine users set forth in the system descriptions for Overseas Citizen Services
Records (State–05) and Passport Records (State–26) published in the Federal Register.
CONSEQUENCES OF FAILURE TO PROVIDE INFORMATION: With the exception of your Social Security Number (see Federal Tax Law
statement on Instruction Page 3), you are not legally required to provide the information requested on this form. However, failure to do so
may result in Passport Services’ refusal to accept your application or result in the denial of a U.S. passport.
PRIVACY ACT STATEMENT
ELECTRONIC PASSPORT STATEMENT
NOTICE TO APPLICANTS FOR OFFICIAL, DIPLOMATIC, OR NO–FEE PASSPORTS
You may use this application if you meet all of the provisions listed on Instruction Page 2, however you must CONSULT YOUR SPONSORING
AGENCY FOR INSTRUCTIONS ON PROPER ROUTING PROCEDURES BEFORE FORWARDING THIS APPLICATION. Your completed passport
will be released to your sponsoring agency for forwarding to you.
The State Department has begun issuing a new type of passport book containing an embedded electronic chip and called an “Electronic
Passport”. The new passport book continues to be proof of the bearer’s United States citizenship/nationality and identity, and looks and
functions in the same way as a passport without a chip. The addition of an electronic chip in the back cover enables the new passport book
to carry a duplicate electronic copy of all information from the data page. The new passport book is usable at all ports–of–entry, including
those that do not yet have electronic chip readers.
Use of the electronic format provides the traveler the additional security protections inherent in chip technology. Moreover, when used at
ports–of–entry equipped with electronic chip readers, the new passport book provides for faster clearance through some of the port–of–entry
processes.
The new passport book does not require special handling or treatment, but like previous versions should be protected from extreme bend-
ing and from immersion in water. The electronic chip must be read using specially formatted readers, which protects the data on the chip
from unauthorized reading.
The cover of the new passport book is printed with a special symbol representing the embedded chip. The symbol
will appear in
port–of–entry areas where the electronic passport book can be read.
APPLICATION FOR A U.S. PASSPORT BY MAIL
2” x 2”
2” x 2”
Submit two recent,
color photographs
From 1” to
1 3/8”
>
>
>
>
x _________________________________________________
Applicant’s Signature
_________________________________________________
Date
This section for issuing ofce only
Marriage Certicate Date of Marriage/Place Issued:
Court Order Date Filed/Court:
Attached:
10. Passport Book or Passport Card Information
Your name as listed on your most recent passport or passport card
Most recent passport book or passport card Issue date
(mm/dd/yyyy)
11. Name Change Information -
Complete if name is different than last passport book or passport card
Place of Name Change
(City/State)
Date
(mm/dd/yyyy)
Changed by Marriage
Changed by Court Order
Page 1 of 2
DS-82 02-2008
End. #__________
Exp ____________
D O DP
R
Please submit marriage certicate or court order to support your name change.
Other:
OMB APPROVAL NO. 1405-0020
EXPIRATION DATE: 12-31-2010
ESTIMATED BURDEN: 40 MIN
9. Have You Ever Used A Different Name
(Maiden, Previous Marriage, Legal Name Change)? If yes, please complete.
(Attach additional pages if needed)
1. Name
Last
2. Date of Birth
(mm/dd/yyyy)
Home
Work
Cell
-
7. Contact Phone Number
2.1.
- -
-
8. Email Address
(Optional)
First & Middle
Please select the document (or documents) for which you are applying:
The U.S. passport card may only be used for international travel by land or sea between the United States,
Canada, Mexico, the Caribbean and Bermuda. Please visit our website for detailed information.
U.S. Passport Book
U.S. Passport Card
Attention: see WARNING on page two of instructions
YOU MUST SIGN AND DATE THE APPLICATION IN THE DESIGNATED AREA BELOW
I declare under penalty of perjury all of the following: 1)I am a citizen or non-citizen national of the United States and have not, since acquiring U.S. citizenship or nationality,
performed any of the acts listed under “Acts or Conditions” on the reverse side of this application (unless explanatory statement is attached); 2)the statements made on the
application are true and correct; 3)I have not knowingly and willfully made false statements or included false documents in support of this application; 4)the photograph
submitted with this application is a genuine, current, photograph of me; and 5)I have read and understood the warning on page two of the instructions to the application form.
CONTINUE TO PAGE 2 >
>
EF________ Postage________ Other________
PPT Fee________
5. Social Security Number
3. Sex
M
F
4. Place of Birth
(City & State or City & Country as it is presently known)
--
State
6. Mailing Address:
Street/RFD # or P.O. Box
In Care Of or Country, if applicable
City
Apartment or unit #
STAPLE
STAPLE
STAPLE
STAPLE
Zip Code
(Zip + 4 if known)
20. Travel Plans
19. Emergency Contact -
Provide the information of a person not traveling with you to be contacted in the event of an emergency.
17. Additional Contact Phone Numbers
12. Height 13. Hair Color 14. Eye Color 15. Occupation 16. Employer
Home
Work
Cell
___________
Home
Work
Cell
___________
State Zip CodeCity
Date of Trip
(mm/dd/yyyy)
Length of Trip Countries to be visited
STOP! YOU HAVE COMPLETED YOUR APPLICATION
BE SURE TO SIGN AND DATE PAGE ONE
Page 2 of 2
DS-82 02-2008
Name of Applicant
(Last, First & Middle)
Date of Birth
(mm/dd/yyyy)
18. Permanent Address:
Street/RFD # (No P.O. Box)
Address: Street/RFD # or P.O. Box
City
Name
State
Zip Code
Relationship
Phone Number
Apartment or unit #
Apartment or unit #
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