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DS-5504 2016 free printable template

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APPLICATION FOR A U.S. PASSPORT CORRECTIONS, NAME CHANGE WITHIN 1 YEAR OF PASSPORT ISSUANCE, AND LIMITED PASSPORT HOLDERSPLEASE DETACH AND RETAIN THIS INSTRUCTION SHEET FOR YOUR RECORDS Mailing Date
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How to fill out DS-5504

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How to fill out DS-5504

01
Obtain the DS-5504 form from the U.S. Department of State's website or a local Passport Acceptance Facility.
02
Fill in your personal information, including your name, date of birth, and address.
03
Provide the passport number if you have one, or other identifying information.
04
Indicate the reason for requesting a new passport card, such as a name change or damaged card.
05
Include supporting documents as required, such as proof of name change or identification.
06
Sign and date the form at the bottom.
07
If applicable, include payment for any fees associated with the request.
08
Mail the completed DS-5504 form and any supporting documents to the address specified in the instructions.

Who needs DS-5504?

01
Individuals who need to request a new passport card due to a name change, loss, damage, or other reasons.

Who needs a DS-5504 form?

An eligible individual who wants to apply for a US passport should complete this form. An eligible individual is a US citizen who has changed their name and the US passport was issued less than one year ago; the information in their previous passport was incorrect; or the previous US passport was limited in validity and issued less than one year ago.

What is the purpose of the DS-5504 form?

This form provides the personal information about the applicant which is required to issue a US passport. The US passport exists in card and book format. The passport in card format is not valid for international air travel.

What documents must accompany the DS-5504 form?

The application for US passport should be accompanied by the most recent US passport; a recent color photograph (the photo requirements are listed on the second page of the form); evidence to support a name change (birth certificate or marriage certificate) or other data change. All the supporting documents (except the photos) will be returned to the applicant.

When is the DS-5504 form due?

This application is completed when there is a need. The estimated time for completing the form is 60 minutes.

What information should be provided in the DS-5504 form?

The application asks for the following details from the applicant:

  • Type of the required document (Passport book, Passport Card, Both)
  • Applicant’s name
  • Applicant’s date and place of birth
  • Applicant’s social security number
  • Mailing address
  • Passport book and/or passport card information
  • Applicant’s appearance (height, hair color, eye color)
  • Occupation
  • Employer or school
  • Emergency contact
  • Travel plans
  • Reason of applying for a new passport

The applicant should also sign and date the form.

What do I do with the application after the completion?

The completed form is forwarded to National Passport Processing Center, Philadelphia, PA.

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People Also Ask about

If you are changing your name within one year of the date your passport was issued, you will need to complete Form DS-5504: Name Change, Data Correction, and Limited Passport Book Replacement. If you are changing your name more than a year after your passport was issued, you must submit Form DS-82: Renewal Application.
To change your name in the passport, you have to apply for "Re-issue" of passport. To check the complete list of documents to be submitted along with the application form, please click on "Documents Advisor" link on Home page.
You qualify to have your passport replaced using a DS-5504 form; this form can only be used to replace limited validity passports (emergency passports) and passports that had an error when they were printed within a year of its issue date.
It usually takes around 3 weeks to 1 month but it can vary based on other situations. Also, you have to pay a standard 1500 Rupees fee for reissuing your passport or for the passport name change.
It may take up to 2 weeks for applications to arrive by mail at a passport agency or center, and up to 2 weeks for you to receive a completed passport in the mail after we print it.
It's quite easy to apply for a passport name change online. Applicants need to follow these steps: Step 1: Fill in the online application form (DS-82 or DS-5504) with details, such as name, address, and birth date. Check if there aren't spelling errors and if all information is correct.
Any error on your passport MUST be corrected otherwise your passport may not be considered valid to use for travel. If the error is a minor error (minor spelling error for example), then you may be able to still use that passport for travel and update it once you return.

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DS-5504 is the application form used to apply for a U.S. passport renewal or to replace a lost, stolen, or damaged passport.
Individuals who need to renew their passport, or obtain a replacement for a lost, stolen, or damaged passport are required to file DS-5504.
To fill out DS-5504, complete the form with accurate personal information, provide a recent passport photo, and submit it along with the required payment and additional documentation.
The purpose of DS-5504 is to facilitate the process of renewing or replacing U.S. passports for eligible applicants.
Information required on DS-5504 includes the applicant's full name, date of birth, passport number, and contact information, as well as details about the existing passport and the reason for renewal or replacement.
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