Form DS-5504 Application for a U.S. Passport for Eligible Individuals - Correction, Name Change to Passport Issued 1 Year Ago or Less, and Limited Passport Replacement

Form DS-5504 Application for a U.S. Passport for Eligible Individuals - Correction, Name Change to Passport Issued 1 Year Ago or Less, and Limited Passport Replacement

What Is Form DS-5504?

Form DS-5504, Application for a U.S. Passport, Corrections, Name Change Within 1 Year of Passport Issuance, and Limited Passport Holders , is a formal statement required to obtain a replacement of the previously issued U.S. passport book or card - a document that allows individuals to enter or exit the country and access consular assistance outside the country.

Alternate Names:

  • Application for a US Passport;
  • Passport Correction Form.

Prepare this form in the following circumstances:

  1. You already have a passport book or card issued less than a year ago and in that period of time you have changed your name.
  2. The details in your passport book or card are incorrect.
  3. You want to replace a limited validity passport you received outside the country in an emergency situation, due to a new name or gender marker, or while you are waiting for a new version of your naturalization certificate.

This document was released by the U.S. Department of State on April 1, 2022 , with all previous editions obsolete. A DS-5504 fillable form is available for download below.

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How to Fill Out Form DS-5504?

Here is how you have to complete the DS-5504 Form:

  1. Enter the date you are mailing the application, check the box that confirms your eligibility to file this application, and specify the document you want to apply for - it can be a passport book, passport card, or both. Besides, you may choose between a regular and large passport book (opt for the latter if you travel often).
  2. Write down your full name, date and place of birth, gender, and social security number . Provide your contact details - email address, telephone number, and mailing address.
  3. List other names you have used in the past - if you do not have enough space, you may add more pages to your application.
  4. Record the details of the passport book or card you received last - your full name as it appears on this document, its number, and the date of issuance.
  5. Sign the document - do not include your full name on the signature line. If the application is filed by a minor, the papers must be examined and signed by their parent or legal guardian as well.
  6. Indicate your biographical details - height, hair color, and eye color. Specify your occupation if you are an adult and write down the name of your employer or educational institution.
  7. Provide two more telephone numbers the Department can call in case there are questions or concerns and your own number is not available . The form should also include an emergency contact - an address of the person that will not travel with you and can be notified in the event of an accident.
  8. State your permanent residential address if it differs from the mailing address the document already contains.
  9. Briefly outline your travel plans - the dates of departure and return and the names of countries you are going to visit.
  10. Certify you qualify to replace a passport book or card by checking the box that applies to your situation . For example, if your name changed since the documentation was issued, the form has to specify your new name. All eligibility criteria are followed by the list of documents you have to submit to ensure your application is successful.

Where Do I Get a DS-5504 Form?

You may use an electronic version of the Form DS-5504 we provide and fill it out on your computer. Once the document is ready, print it out, sign the application, attach a photograph, and send it with supporting documentation to the U.S. Department of State - the mailing address is National Passport Processing Center, P.O. Box 90107, Philadelphia, PA 19190-0107.

What Do I Need for a US Passport Application?

Attach the following documents to Form DS-5504 to make sure your application is accepted and processed without delay:

  1. Passport book or card you have in your possession.
  2. Color photograph of you, 2x2 inches, taken less than half a year ago . It must be stapled to the application.
  3. Documents that verify your eligibility to submit the passport application - for instance, a copy of the birth certificate may be necessary if you noticed an error in your name in the passport.
  4. A service fee is required if you are filing a form because you have changed your name or need to replace a limited passport.

Other Revision

Download Form DS-5504 Application for a U.S. Passport for Eligible Individuals - Correction, Name Change to Passport Issued 1 Year Ago or Less, and Limited Passport Replacement

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  • Form DS-5504 Application for a U.S. Passport for Eligible Individuals - Correction, Name Change to Passport Issued 1 Year Ago or Less, and Limited Passport Replacement

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  • Form DS-5504 Application for a U.S. Passport for Eligible Individuals - Correction, Name Change to Passport Issued 1 Year Ago or Less, and Limited Passport Replacement, Page 2

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  • Form DS-5504 Application for a U.S. Passport for Eligible Individuals - Correction, Name Change to Passport Issued 1 Year Ago or Less, and Limited Passport Replacement, Page 3

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  • Form DS-5504 Application for a U.S. Passport for Eligible Individuals - Correction, Name Change to Passport Issued 1 Year Ago or Less, and Limited Passport Replacement, Page 4

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  • Form DS-5504 Application for a U.S. Passport for Eligible Individuals - Correction, Name Change to Passport Issued 1 Year Ago or Less, and Limited Passport Replacement, Page 5

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  • Form DS-5504 Application for a U.S. Passport for Eligible Individuals - Correction, Name Change to Passport Issued 1 Year Ago or Less, and Limited Passport Replacement, Page 6

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  • Form DS-5504 Application for a U.S. Passport for Eligible Individuals - Correction, Name Change to Passport Issued 1 Year Ago or Less, and Limited Passport Replacement, Page 1
  • Form DS-5504 Application for a U.S. Passport for Eligible Individuals - Correction, Name Change to Passport Issued 1 Year Ago or Less, and Limited Passport Replacement, Page 2
  • Form DS-5504 Application for a U.S. Passport for Eligible Individuals - Correction, Name Change to Passport Issued 1 Year Ago or Less, and Limited Passport Replacement, Page 3
  • Form DS-5504 Application for a U.S. Passport for Eligible Individuals - Correction, Name Change to Passport Issued 1 Year Ago or Less, and Limited Passport Replacement, Page 4
  • Form DS-5504 Application for a U.S. Passport for Eligible Individuals - Correction, Name Change to Passport Issued 1 Year Ago or Less, and Limited Passport Replacement, Page 5
  • Form DS-5504 Application for a U.S. Passport for Eligible Individuals - Correction, Name Change to Passport Issued 1 Year Ago or Less, and Limited Passport Replacement, Page 6
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