Form DS-5504, Passport Correction Instructions

Enter the full name of the applicant.

Enter the date of birth of the applicant in the format mm/dd/yyyy.

Enter the height of the applicant in feet and inches.

Enter the hair color of the applicant.

Enter the eye color of the applicant.

Enter the current occupation of the applicant.

Enter the name of the employer or school of the applicant.

Check this box when you are applying for a U.S. passport book (the traditional passport) as one of the documents you are requesting.

Enter your family or last name exactly as you want it to appear on the passport.

Enter your first or given name as you want it to appear on the passport.

Enter your middle name or initial as it should appear on the passport, or leave blank if you have none.

Check this box if you are applying for a limited passport replacement.

Enter any additional contact phone numbers for the applicant.

Check this box if the additional contact number is a home phone.

Check this box if the additional contact number is a cell phone.

Enter any additional contact phone numbers for the applicant.

Check this box if the second additional contact number is a home phone.

Check this box if the second additional contact number is a cell phone.

Check this box if the additional contact number is a work phone.

Check this box if the additional contact number is another type of phone.

Check this box if the second additional contact number is a work phone.

Check this box if the second additional contact number is another type of phone.

Enter your last name as it is incorrectly printed on your current passport.

Check this box if your name is printed incorrectly on your current passport.

Check this box if your name is not printed incorrectly on your current passport.

Enter your first name as it is incorrectly printed on your current passport.

Enter your middle name as it is incorrectly printed on your current passport.

Enter your corrected date of birth.

Check this box if your corrected gender is male.

Check this box if your corrected gender is female.

Check this box if your corrected gender is non-binary.

Enter your corrected place of birth.

Check this box when you are applying specifically for a U.S. Passport Card (use this option if you want the passport card rather than the passport book).

Enter the month of your birth as a one- or two-digit number (MM), e.g., 1 or 01 for January.

Enter the day of your birth as a one- or two-digit number (DD), e.g., 5 or 05 for the fifth day of the month.

Enter the four-digit year you were born.

Select this option if you have changed your name.

Select this option if you have not changed your name.

Select this option if the information printed on your passport is incorrect.

Select this option if the information printed on your passport is correct.

Select this option if you have a limited passport book.

Select this option if you do not have a limited passport book.

Check this box if the applicant's gender is male (select the 'M' gender marker).

Enter the applicant's email address where passport application status and communications can be sent.

Enter the name of the emergency contact person.

Enter the full address of your emergency contact.

Enter the apartment or unit number of your emergency contact's address, if applicable.

Enter the city of your emergency contact's address.

Enter the state of your emergency contact's address.

Enter the zip code of your emergency contact's address.

Enter the phone number of your emergency contact.

Specify your relationship to the emergency contact (e.g., spouse, parent, friend).

Click this button to clear the form.

Check this box if you are applying for a limited passport replacement.

Check this box if you are requesting a change to your gender marker on your passport (i.e., you want your gender designation on the passport changed).

Enter the primary mailing address including street number and name, rural route (RFD#), P.O. Box, or URB.

Enter secondary address information such as apartment, suite, unit, or additional delivery instructions; if the applicant is a child, write 'In Care Of' followed by the parent's name.

Enter the city of your mailing address.

Enter the U.S. state or territory for your mailing address (abbreviation or full name as appropriate).

Enter the postal ZIP code for your mailing address.

If your mailing address is outside the United States, enter the country name; otherwise leave this field blank or enter 'United States' if requested.

Enter your new last name if you have changed it.

Check this box if you are applying for a name change.

Check this box if you are not applying for a name change.

Enter your new first name if you have changed it.

Enter your new middle name if you have changed it.

Check this box if you are requesting a change to your gender marker on your passport (i.e., you are changing the gender designation).

Enter the first alternate or previously used full name (for example, birth name, maiden name, name from a previous marriage, or legally changed name) exactly as it appeared when you used it.

Enter a second alternate or previously used full name (birth name, maiden name, previous married name, or legal name change) exactly as it appeared when you used it; attach additional pages if needed.

Check this box if you are applying for a U.S. Passport Book (the standard passport booklet used for international travel).

Enter the street address of the applicant's permanent address.

Enter the apartment or unit number of the applicant's permanent address.

Enter the city of the applicant's permanent address.

Enter the state of the applicant's permanent address.

Enter the zip code of the applicant's permanent address.

Check this box if you are applying for a regular (standard) U.S. passport book.

Enter the city and state if born in the U.S., or the city and country as it is presently known, for your place of birth.

Check this box if the applicant's gender marker is X (non-binary/unspecified).

Enter the primary contact’s 3-digit telephone area code (numbers only, no parentheses or dashes).

Enter the next three digits of the primary contact’s telephone number (first three digits of the local number, numbers only).

Enter the final four digits of the primary contact’s telephone number (numbers only).

Check this box if you are applying for a large-sized passport book.

Enter the first three digits of your Social Security Number (the Area Number).

Enter the middle two digits of your Social Security Number (the Group Number).

Enter the last four digits of your Social Security Number (the Serial Number).

Enter the date you plan to depart for your travel.

Enter the date you plan to return from your travel.

List the countries you plan to visit during your travel.

Enter your full name exactly as it appears on your most recent U.S. passport book and/or passport card. Fill only if 'U.S. Passport Book', 'U.S. Passport Card', 'U.S. Passport Book' is 'Yes' if any.

Provide the passport book number from your most recent U.S. passport book. Fill only if 'U.S. Passport Book', 'U.S. Passport Book' is 'Yes' if any.

Provide the date when your most recent passport book was issued. Fill only if 'U.S. Passport Book', 'U.S. Passport Book' is 'Yes' if any.

Provide the passport card number from your most recent U.S. passport card. Fill only if 'U.S. Passport Card', 'U.S. Passport Book' is 'Yes' if any.

Provide the date when your most recent passport card was issued. Fill only if 'U.S. Passport Card', 'U.S. Passport Book' is 'Yes' if any.