🔒 DS-11 / DS64 SECURE ONLINE PASSPORT APPLICATION

Step 1 of 8

Please select the type of Passport you are applying for*
- Passport Book
- Passport Card
- Both
Indicate if you want just the book (traditional passport), just a card (a card valid to enter Mexico and Canada only), or both.
What size of Passport Book do you want?*
- Regular 28 pages
- Large 52 pages
If you travel often, you can request a large passport (52 pages), otherwise you can request a regular size (28 pages). There is no extra cost for the large format.
About the Applicant
First Name*
Middle Name
Last Name*
Suffix
Enter any suffix your name may legally contain (ex: Jr, Sr ). DO NOT enter Mr, Ms, or Mrs

Applicant Date of Birth*
Month
Day
Year
Enter your date of birth using (MM/DD/YYYY) format
City of Birth*
Country of Birth*
State / Territory of Birth*
Please choose the state/territory of your birth if you were born in the USA
Applicant Gender*
- Male
- Female
Height
Ft*
Enter the "feet" portion of your height
Inches*
Enter the "inches" portion of your height
Hair Color*
Choose the hair color that is closest to your hair color
Eye Color*
Choose the eye color that is closest to your eye color
Occupation*
Occupation is mandatory for adults and must be completed as descriptively as possible if a title alone will not make it clear. If you are not employed, state so in the occupation field. If you are self-employed, the type of work you perform should be completed in occupation and self-employed in employer. Children should enter STUDENT or CHILD in the occupation field.
Employer / School
Enter the name of the company where you work or the name of your school if you are a student. This field is optional and so you may choose not to enter any information.

Travel Plans (Optional)
Date of Your Next Trip
Month
Day
Year
Please enter the date (MM/DD/YYYY) you expect to travel to a foreign country
Date of Your Return
Month
Day
Year
Countries To Be Visited
Emergency Contact (Optional)
First & Last Name
Please enter the name of a contact person who will not be traveling with you
Emergency Contact Address
Street Address Address Line 2 City State Zip Code
Telephone Number
Relationship to Applicant
Enter the contact's relationship to the applicant, such as father, mother, sister, brother, spouse, friend

Passport Application Forms
PDF Form Generation*
- 44.50
TOTAL AMOUNT
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Credit Card*
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Billing Address
- Same as Mailing Address
Enter Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Terms of Use*
- By clicking this box I agree with the Terms of Use. I also confirm that I understand that the US Department of State supplies blank forms and instructions free of charge. Nevertheless, I wish to use this PDF assistant with personalized instructions.
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Last 4 Social Security*

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🔒 DS-11 / DS64 SECURE ONLINE PASSPORT APPLICATION

Step 1 of 8

About the Applicant

Addresses

Travel Plans (Optional)

Emergency Contact (Optional)

Previous Passports

Your Most Recent Passport Book

Your Most Recent Passport Card

Lost or Stolen Passport Book Information

Lost or Stolen Passport Card Information

Other Passports Lost / Stolen

Parent and Spouse Information

List All Other Legal Names You Have Used

Passport Application Forms

🔒 Secure Payment 🔒

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