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CAN I USE THIS FORM? - State

I can submit my most recent passport book and/or passportcard with this application. I was at least 16 years old when my most recent passport book and/or passport card was issued. I was issued my most recent passport book and/or passportcard less than 15 years ago. The passport book and/or passport card that I am renewing has not been mutilated, damaged, lost, stolen or subsequently passport has not been limited from the normal ten year validity period due to passport damage/mutilation, multiple passportthefts/losses, or non-compliance with 22 (Pleaserefer to the back pages of your passport book for endorsement information). I use the same name as on my most recent passport book and/or passport have had my name changed by marriage or court order and cansubmit proper certified documentation to reflect my name change.

United States citizens residing outside the U.S. or Canada CANNOT submit this form to domestic addresses listed on the Instruction Page 2. Such applicants Such applicants should visit www.usembassy.gov to find the nearest U.S. Embassy or Consulate for procedures for applying outside the United States.

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