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 Replacement Form: DS-5504 Minimize

Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement Form: DS-5504

 

PLEASE PRINT OUT AND SUBMIT ONLY ONE-SIDED PAGES OF THE APPLICATION.

Please type or print legibly in black ink when completing all sections of this application.
This form should only be used for making a data change for a previously issued, currently valid U.S. passport WITHIN one year from the date of issue:
  • When there is a change in your identifying information, such as a name-change due to marriage or by court order;
  • To extend the validity of certain previously limited passports; or
  • To correct a Passport Services’ printing error.
There is no charge for routine service , which is receipt of your replacement passport within 6-8 weeks from the date you submit it.
If Expedited Service is requested for any of the above, with the exception of an error by Passport Services, there is an additional charge of $60 per application, plus the cost of two-way overnight delivery for receipt within about 3 weeks from the date you submit your application. Please write "Expedite" clearly on the envelope.  For Expedited Service at a Regional Passport Agency, there is a $60.00 fee per application.
When submitting, please include:
  • Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement Form DS-5504,
  • The passport to be replaced,
  • The documentation required for the change (see Instruction Page 2 of the form), and
  • New photos.
  • Application for a U.S. Passport: Name Change, Data Correction, and Limited Passport Book Replacement Form DS-5504,
     
  • The passport to be replaced,
  • The documentation required for the change (see Instruction Page 2 of the form), and
  • New photos.

Please follow the instructions on the form carefully. Complete, sign, and date the application.

If it is MORE than one year since the date of issue , you must submit Form DS-82 (or DS-11, if appropriate) and pay the applicable fees. For more information on Form DS-82.

Printing Errors by Passport Services.
If there is a printing error due to Passport Services and your passport was issued less than 30 days ago, please submit the following:
  • A letter explaining the specific correction needed and the date by which the corrected passport is needed;
  • The passport containing the printing error;
  • A completed form DS-5504;
  • The documentation required for the change (see Instruction Page 2 of the form), and
  • New photos.
If it has been more than 30 days since your passport was issued, please submit the following:
  • Two new passport photos;
  • A letter explaining the specific correction needed and the date by which the corrected passport is needed;
  • The passport containing the printing error; and
  • A completed form DS-5504
Please send the above documentation and form to the address above.  There is no fee to request a corrected passport if the cause is a printing error by Passport Services regardless of the age of the valid passport.  
  
 Documents Minimize
 TitleModified DateSize (Kb) 
Replacement Form: DS-55042/27/2014UnknownDownload
Authorization Letter2/27/201486.52Download
  
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