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U.S. PASSPORT APPLICATION

WARNING: False statements made knowingly and willfully in PASSPORT applications , including affidavits or other documents submitted to supportthis APPLICATION , are punishable by fine and/or imprisonment under law including the provisions of 18 1001, 18 1542, and/or 1621. alteration or mutilation of a PASSPORT issued pursuant to this APPLICATION is punishable by fine and/or imprisonment under theprovisions of 18 1543. The use of a PASSPORT in violation of the restrictions contained herein or of the PASSPORT regulations is punishableby fine and/or imprisonment under 18 1544.

Alteration or mutilation of a passport issued pursuant to this application is punishable by fine and/or imprisonment under the ... z The passport application fee, security surcharge, and expedite fee may be paid in any of the following forms: ... name and surname, date and/or place of birth, and the seal or other certification of the office (if ...

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