Lost/Stolen Passport Application
A U.S. citizen may not normally bear more than one valid or potentially valid U.S. passport book and one valid passport card at a time. It therefore is necessary to submit a statement with an application for a new U.S. passport when a previously issued valid or potentially valid U.S. passport cannot be presented. Your statement must detail why the previous U.S. passport cannot be presented. The information you provide on the DS-64, Statement Regarding a Lost or Stolen Passport, will be placed into our Consular Lost or Stolen Passport System. This system is designed to prevent the misuse of your lost or stolen U.S. passport. Anyone using the passport reported on the DS-64, including yourself, may be detained upon entry into the United States. Should you locate the passport reported lost or stolen at a later time, you should report it as found and submit it for cancellation. It has been invalidated. You may not use that passport for travel.
HOW TO REPORT YOUR LOST OR STOLEN PASSPORT:
If you are applying for a new passport, please submit this form with the new passport application to any designated acceptance facility, passport agency, or U.S. consular official.
If you are not currently applying for a new passport, send this form or a recovered lost or stolen passport to the following address:
U.S. Department of State
Consular Lost/Stolen Passport Section
1111 19th Street, NW, Suite 500
Washington, DC 20036
(Please do not attempt to use this address for any passport related service other than that described above.)
To report your lost or stolen passport by phone, call: 202-955-0430.
Or visit our website: www. travel state.gov
False statements made knowingly and willfully in passport applications or in affidavits or other supporting documents submitted therewith are punishable by fine and/or imprisonment under the provisions of 18 U.S.C 1001 and/or 18 U.S.C. 1542. Alteration or mutilation of a U.S. passport is punishable fine and/or imprisonment under the provisions of 18 U.S.C 1543. The use of a U.S. passport in violation of the restrictions contained therein or of the passport regulations is punishable fine and/or imprisonment under 18 U.S.C. 1544. All statements and documents submitted are subject to verification.
PRIVACY ACT AND PAPERWORK REDUCTION ACT STATEMENTS
The information solicited on this form is requested pursuant to provisions 22 U.S.C. 211a, et seq.; Executive Order 11295 (August 5, 1966); Title 22, Part 51, Code of Federal Regulations (CFR); and in particular 22 CFR 51.2(b) and 51.8(b).
The primary purpose for soliciting the information is to ensure that no person shall bear more than one valid or potentially valid United States passport book and one valid passport card at any one time, except as authorized by the U.S. Department of State, and to combat passport fraud and misuse.
The information solicited on this form may be made available as a routine use to other government
agencies, to assist the U.S. Department of State in adjudicating passport applications and requests for related
services, and for law enforcement and administrative purposes. It may also be disclosed pursuant to court order.
The information may be made available to foreign government agencies to fulfill passport control and immigration
duties or to investigate or prosecute violations of law. The information may also be made available to private U.S.
citizen 'wardens' designated by U.S. embassies and consulates.
CONSEQUENCES OF FAILURE TO PROVIDE INFORMATION:
Except as noted, failure to provide the information requested on this form may result in the denial of a United States passport, related documents, or service to the individual seeking such passport, documents, or service. The disclosure of your social security number on this form is voluntary and in accordance with the authorities listed above and will be used in the processing of your statement regarding your lost or stolen passport and as described in the preceding paragraphs.
*Public reporting burden for this collection of information is estimated to average 5 minutes per response, including time required for searching existing data sources, gathering the necessary data, providing the information and/or documents required, and reviewing the final collection. You do not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments on the accuracy of this burden estimate and/or recommendations for reducing it, please sent them to: A/GIS/DIR, Room 2400 SA-22, U.S. Department of State, Washington, DC 20522-2202.
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1801 Columbia Road, NW • Suite 200 • Washington, D.C. 20009
Fax: (202) 387-5430