美国公民护照申请表格-DS-11

WARNING:Falsestatementsmadeknowinglyandwillfullyinpassportapplications,includingaffidavitsorotherdocumentssubmittedtosupportthisapplication,arepunishablebyfineand/orimprisonmentunderU.S.lawincludingtheprovisionsof18U.S.C.1001,18U.S.C.1542,and/or18U.S.C.1621.Alterationormutilationofapassportissuedpursuanttothisapplicationispunishablebyfineand/orimprisonmentundertheprovisionsof18U.S.C.1543.Theuseofapassportinviolationoftherestrictionscontainedhereinorofthepassportregulationsispunishablebyfineand/orimprisonmentunder18U.S.C.1544.Allstatementsanddocumentsaresubjecttoverification.IMPORTANTNOTICETOAPPLICANTSWHOHAVEHADAPREVIOUSU.S.PASSPORTBOOKAND/ORPASSPORTCARDASDIRECTEDBYPUBLICLAW106-113AND22CFR51.28:Tosubmitanapplicationforachildunderage16bothparentsorthechild'slegalguardian(s)mustappearandpresentthefollowing:-Evidenceofthechild'sU.S.citizenship;-Evidenceofthechild'srelationshiptoparents/guardian(s);AND-Parental/guardiangovernment-issuedidentification.IFONLYONEPARENTAPPEARS,YOUMUSTALSOSUBMITONEOFTHEFOLLOWING:-Secondparent'snotarizedwrittenstatementorDS-3053(includingthechild'sfullnameanddateofbirth)consentingtothepassportissuanceforthechild.Thenotarizedstatementcannotbemorethanthreemonthsoldandmustbesignedandnotarizedonthesameday,andmustcomewithaphotocopyofthefrontandbacksideofthesecondparent'sgovernment-issuedphotoidentification;OR-Secondparent’sdeathcertificateifsecondparentisdeceased;OR-Primaryevidenceofsoleauthoritytoapply;OR-AwrittenstatementorDS-5525(madeunderpenaltyofperjury)explainingindetailthesecondparent'sunavailability.ASDIRECTEDBYREGULATION22C.F.R.51.21AND51.28:-EachminorchildapplyingforaU.S.passportbookand/orpassportcardmustappearinperson.SPECIALREQUIREMENTSFORCHILDRENFAILURETOPROVIDEINFORMATIONREQUESTEDONTHISFORM,INCLUDINGYOURSOCIALSECURITYNUMBER,MAYRESULTINSIGNIFICANTPROCESSINGDELAYSAND/ORTHEDENIALOFYOURAPPLICATION.INFORMATION,QUESTIONS,ANDINQUIRIESU.S.PASSPORTS,EITHERINBOOKORCARDFORMAT,AREISSUEDONLYTOU.S.CITIZENSORNON-CITIZENNATIONALS.EACHPERSONMUSTOBTAINHISORHEROWNU.S.PASSPORTBOOKORU.S.PASSPORTCARD.THEPASSPORTCARDISAU.S.PASSPORTISSUEDINCARDFORMAT.LIKETHETRADITIONALU.S.PASSPORTBOOK,ITREFLECTSTHEBEARER'SORIGIN,IDENTITY,ANDNATIONALITYANDISSUBJECTTOEXISTINGPASSPORTLAWSANDREGULATIONS.UNLIKETHEU.S.PASSPORTBOOK,THEU.S.PASSPORTCARDISVALIDONLYFORENTRYTOTHEUNITEDSTATESATLANDBORDERCROSSINGSANDSEAPORTSOFENTRYWHENTRAVELINGFROMCANADA,MEXICO,THECARIBBEAN,ANDBERMUDA.THEU.S.PASSPORTCARDISNOTVALIDFORINTERNATIONALAIRTRAVEL.Pleasevisitourwebsiteattravel.state.gov.Inaddition,youmaycontacttheNationalPassportInformationCenter(NPIC)toll-freeat1-877-487-2778(TDD:1-888-874-7793)[e-mail]ativesareavailableMonday-Friday8:00a.m.-10:00p.m.EasternTime(excludingfederalholidays).Automatedinformationisavailable24hoursaday,7daysaweek.APPLICATIONFORAU.S.PASSPORTPLEASEDETACHANDRETAINTHISINSTRUCTIONSHEETFORYOURRECORDSIapplied:DS-1109-2013Place:Date:InstructionPage1of4WHATTOSUBMITWITHTHISFORM:1.PROOFOFU.S.CITIZENSHIP(EvidenceofU.S.citizenshipthatisnotdamaged,altered,orforgedwillbereturnedtoyou.)2.PROOFOFIDENTITY(YoumustpresentyouroriginalidentificationANDsubmitaphotocopyofthefrontandbacksidewithyourpassportapplication.)3.RECENTCOLORPHOTOGRAPH(Photographmustmeetpassportrequirements–fullfrontviewofthefaceand2x2inchesinsize.)4.FEES(Pleasevisitourwebsiteattravel.state.govforcurrentfees.)WHERETOSUBMITTHISFORM:Pleasecompleteandsubmitthisapplicationinpersontooneofthefollowingacceptanceagents:aclerkofafederalorstatecourtofrecordorajudgeorclerkofaprobatecourtacceptingapplications;adesignatedmunicipalorcountyofficial;adesignatedpostalemployeeatanauthorizedpostoffice;anagentatapassportagency(byappointmentonly);oraU.S.consularofficialataU.S.EmbassyorConsulate,ifabroad.Tofindyournearestacceptancefacility,visittravel.state.govorcontacttheNationalPassportInformationCenterat1-877-487-2778.LOSTORSTOLEN-YouarerequiredtosubmitaFormDS-64,StatementRegardingaLostorStolenU.S.Passport,whenyourvalidorpotentiallyvalidU.S.passportbookand/orpassportcardcannotbesubmittedwiththisapplication.INMYPOSSESSION-IfyourmostrecentU.S.passportbookand/orpassportcardwasissuedlessthan15yearsago,andyouwereovertheageof16atthetimeofissuance,youmaybeeligibletouseFormDS-82torenewyourpassportbymail.Ifyourmostrecentpassportisvalidandneedsadditionalpages,youcansubmityourpassport,formDS-4085,andthecurrentfee.Seepage2oftheinstructionsfordetailedinformationonthecompletionandsubmissionofthisform.APPLICATIONFORAU.S.PASSPORTThepassportprocessing,execution,andsecurityfeesmaybepaidinanyofthefollowingforms:Checks(personal,certified,ortraveler's)withtheapplicant'sfullnameanddateofbirthprintedonthefront;majorcreditcard(Visa,MasterCard,AmericanExpress,andDiscover);bankdraftorcashier'scheck;moneyorder(U.S.Postal,international,currencyexchange),orifabroad,theforeigncurrencyequivalent,oracheckdrawnonaU.S.bank.AllfeesshouldbepayabletotheU.S.DepartmentofStateorifabroad,theappropriateU.S.EmbassyorU.S.Consulate.Whenapplyingatadesignatedacceptancefacility,thee