Form DS-11, APPLICATION FOR A U.S. PASSPORT Instructions
This form contains 105 fields organized into 22 sections. Below is a complete list of every field, its type, and what information is expected.
| Field Name | Type | Description |
|---|---|---|
| Applicant Address | ||
| City | Text |
Enter the city of your mailing address.
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| State | Text |
Select or type the U.S. state, territory, or province associated with your mailing address.
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| ZIP Code | Text |
Enter the five-digit ZIP Code (or ZIP+4) for your mailing address.
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| Country (If Outside the United States) | Text |
If your mailing address is outside the U.S., enter the country here; otherwise leave blank.
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| Applicant Information | ||
| Applicant’s Full Name | Text |
Type your legal last name, first name, and middle name exactly as they should appear on your U.S. passport.
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| Applicant’s Date of Birth | Text |
Enter your date of birth in MM/DD/YYYY format.
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| Contact Information | ||
| Email Address | Text |
Provide a valid email address where the Department of State can contact you about your application.
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| Primary Phone – Area Code | Text |
Enter the three-digit area code of your primary contact phone number.
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| Primary Phone – Prefix | Text |
Enter the next three digits of your primary contact phone number.
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| Primary Phone – Line Number | Text |
Enter the last four digits of your primary contact phone number.
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| Additional Contact Phone Number | Text |
List an extra telephone number where you can be reached (include area code).
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| Additional Contact Phone Number Type – Home | CheckBox |
Check this box if the additional contact phone number you have provided is a home phone number.
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| Additional Contact Phone Number – Work | CheckBox |
Check this box if the additional contact phone number you are providing is your work phone number.
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| Additional Contact Phone Number – Cell | CheckBox |
Check this box if the additional contact phone number you entered is a cell phone.
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| Additional Contact Phone Number – Cell | CheckBox |
Check this box if the additional contact phone number you are providing is a cell (mobile) phone number.
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| Emergency Contact | ||
| Emergency Contact – Name | Text |
Enter the full name of the person to contact in case of emergency. This person should not be traveling with you.
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| Emergency Contact – Street/RFD#/P.O. Box | Text |
Provide the street address, rural route, or P.O. Box of your emergency contact.
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| Emergency Contact – Apartment/Unit | Text |
If applicable, enter the apartment, unit, or suite number for your emergency contact’s address.
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| Emergency Contact – City | Text |
Type the city where your emergency contact resides.
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| Emergency Contact – State | Text |
Enter the U.S. state, territory, or province where your emergency contact lives.
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| Emergency Contact – ZIP Code | Text |
Provide the ZIP Code (or postal code) of your emergency contact.
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| Emergency Contact – Phone Number | Text |
List a primary phone number (including area code) for your emergency contact.
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| Emergency Contact – Relationship | Text |
State how this person is related to you (e.g., Parent, Friend, Spouse).
|
| Employment/School Information | ||
| Employer or School Name | Text |
Enter the name of your current employer or the school you attend, if applicable.
|
| Occupation | Text |
If you are 16 or older, state your current occupation or job title. If unemployed or a student, indicate that status.
|
| Form Actions | ||
| Clear | Button |
Click this button to clear the form.
|
| Mailing Address | ||
| Mailing Address Line 1 | Text |
Enter the street address, P.O. Box, or rural route where you want your passport returned.
|
| Mailing Address Line 2 | Text |
Apartment, suite, unit, or ‘In Care Of’ information, if applicable. Leave blank if not needed.
|
| Marital Status | ||
| Have you ever been married? – Yes option | CheckBox |
Check this box if the applicant has ever been married (current or previous marriages).
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| Question 11 – Have you ever been married? No | CheckBox |
Check this box if you have never been married.
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| Date of Marriage | Text |
Enter the date you were married in MM/DD/YYYY format.
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| Widow/Divorce Date | Text |
If applicable, provide the date you became widowed or divorced in MM/DD/YYYY format.
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| Section 11 – Have you ever been widowed or divorced? (Yes) | CheckBox |
Check this box if your most recent marriage ended because you were widowed or divorced.
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| Have you ever been widowed or divorced? – No | CheckBox |
Check this box if you have never been widowed or divorced.
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| Name Change | ||
| Other Name Used – A | Text |
List any other legal name you have ever used (e.g., maiden name, previous married name).
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| Other Name Used – B | Text |
If you have used more than one additional name, list the second name here; otherwise leave blank.
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| Parent 1 Information | ||
| Parent 1 – First & Middle Name (at parent’s birth) | Text |
Provide the first and middle names of your first listed parent as they were at that parent’s birth.
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| Parent 1 – Last Name (at parent’s birth) | Text |
Enter the last name (surname) of your first listed parent at the time of that parent’s birth.
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| Parent 1 – Date of Birth | Text |
Supply the birth date of your first listed parent in MM/DD/YYYY format.
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| Parent 1 – Place of Birth | Text |
Write the city and state (if in the U.S.) or city and country where your first listed parent was born.
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| Row 1 – Gender: Male | CheckBox |
Select this checkbox if the first parent listed in row 1 is male.
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| Row 1: Gender – Female | CheckBox |
In the Parental Information table’s first row (Parent 1), check this box if the first parent’s gender is female.
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| Row 1: U.S. Citizen – Yes | CheckBox |
Select this box if the first parent listed in Row 1 is a United States citizen.
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| Parental Information – Row 1 Gender ‘X’ Checkbox | CheckBox |
Check this box if the first parent’s gender, as recorded at the time of their birth, is non-binary/unspecified (designated ‘X’).
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| Row 1 – U.S. Citizen? No | CheckBox |
Check this box if the first parent listed was not a U.S. citizen at the time of the applicant’s birth.
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| Parent 2 Information | ||
| Parent 2 – First & Middle Name (at parent’s birth) | Text |
Provide the first and middle names of your second listed parent as they were at that parent’s birth.
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| Parent 2 – Last Name (at parent’s birth) | Text |
Enter the last name (surname) of your second listed parent at the time of that parent’s birth.
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| Parent 2 – Date of Birth | Text |
Supply the birth date of your second listed parent in MM/DD/YYYY format.
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| Parent 2 – Place of Birth | Text |
Write the city and state (if in the U.S.) or city and country where your second listed parent was born.
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| Parental Information row 2 – Gender: M | CheckBox |
Check this box if the second parent listed in Section 10 is male.
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| Parent Information (Row 2) – Gender: Female | CheckBox |
Check this box if the second parent’s gender is female.
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| Parental Information Row 2 – U.S. Citizen: Yes | CheckBox |
Check this box if the second listed parent is a U.S. citizen.
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| Parental Information (Row 2) – Gender “X” | CheckBox |
In the second row of the Parental Information section, check this box if that parent’s recorded gender at birth was “X” (other/nonbinary).
|
| Parent Information | ||
| U.S. Citizen? No (Section 10, Row 2 – Second Parent) | CheckBox |
Check this box if the second parent listed in Section 10 is not a U.S. citizen.
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| Passport Book Size | ||
| Row 2: Regular Book (Standard) | CheckBox |
In the fee-selection table (row 2), check this box if you are applying for and paying the fee for the standard/regular U.S. passport book rather than the large (non-standard) book.
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| Large Book (Non-Standard) | CheckBox |
Check this box if you are applying for the large, non-standard U.S. passport book (typically used by frequent international travelers who need extra visa pages).
|
| Passport Book Status | ||
| Table row 1 – Submitting with application (Most recent passport book status) | CheckBox |
Check this box if you are submitting your most recent passport book with your DS-11 application.
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| Most recent passport book status – Stolen | CheckBox |
Check this box if your most recent U.S. passport book was stolen and you need to report it as such.
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| Status of your most recent passport book – Lost (table row 1) | CheckBox |
Check this box if your most recently issued passport book was lost (table row 1).
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| Passport Book Status (Row 1) – In my possession (if expired) | CheckBox |
In the Passport Book Status table (row 1), check this box if your most recent U.S. passport book is currently in your possession, even if it has expired.
|
| Passport Card Status | ||
| Submit the application in person | CheckBox |
Check this box if you must appear in person at a passport acceptance facility (for all first-time adult applications and all new or renewal applications for minors under age 16)
|
| Row 2: Status of your most recent passport card – Stolen | CheckBox |
Check this box if your most recently issued passport card was stolen.
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| Photocopies of identification documents (front and back) | CheckBox |
Check this box if you are submitting one photocopy each of the front and back of the identification document(s) you present when applying for your U.S. passport.
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| Passport Card Status (Row 2) – In my possession (if expired) | CheckBox |
Check this box if your most recent U.S. passport card is in your possession, even if it has expired (table row 2).
|
| Passport History | ||
| Section 21, Have you ever applied for or been issued a U.S. Passport – Yes | CheckBox |
Check this box if you have previously applied for or been issued a U.S. Passport Book or Passport Card.
|
| 21. No – never applied for or been issued a U.S. Passport Book or Passport Card | CheckBox |
Check this box if you have never applied for or been issued a U.S. Passport Book or Passport Card.
|
| Name on Most Recent Passport Book | Text |
If you have held a U.S. passport book, enter the name exactly as it appeared on that book.
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| Most Recent Passport Book Number | Text |
Provide the nine-digit number from your most recent U.S. passport book.
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| Most Recent Passport Book – Issue Date | Text |
Enter the date your most recent passport book was issued in MM/DD/YYYY format.
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| Name on Most Recent Passport Card | Text |
If you have held a U.S. passport card, enter the name exactly as it appeared on that card.
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| Most Recent Passport Card Number | Text |
Provide the number from your most recent U.S. passport card.
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| Most Recent Passport Card – Issue Date | Text |
Enter the date your most recent passport card was issued in MM/DD/YYYY format.
|
| Passport Type Selection | ||
| U.S. Passport Book | CheckBox |
Check this box if you are submitting fees to apply for a U.S. passport book
|
| Select document(s) for which you are submitting fees – U.S. Passport Card (Row 2) | CheckBox |
Check this box if you are submitting fees to apply for a U.S. Passport Card only (i.e. you are applying solely for the passport card).
|
| Both U.S. Passport Book and U.S. Passport Card | CheckBox |
Check this box if you are submitting fees for both a U.S. passport book and a U.S. passport card.
|
| Permanent Address | ||
| Permanent Address – Street/RFD#/URB | Text |
Enter the street address, rural route, or URB of your permanent residence. Do NOT list a P.O. Box here.
|
| Permanent Address – Apartment/Unit | Text |
If applicable, indicate your apartment, unit, or suite number.
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| Permanent Address – City | Text |
Type the city of your permanent residence.
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| Permanent Address – State | Text |
Select or write the U.S. state, territory, or province for your permanent residence.
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| Permanent Address – ZIP Code | Text |
Provide the ZIP Code (or postal code) for your permanent residence.
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| Personal Information | ||
| Last Name | Text |
Enter your current legal last (family) name exactly as it appears on your identity documents.
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| First Name | Text |
Enter your current legal first (given) name exactly as it appears on your identity documents.
|
| Middle Name | Text |
If you have a middle name or initial, type it here. Leave the field blank if you do not have one.
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| Date of Birth – Month | Text |
Type the two-digit month of your birth (01–12).
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| Date of Birth – Day | Text |
Type the two-digit day of your birth (01–31).
|
| Date of Birth – Year | Text |
Type the four-digit year of your birth (e.g., 1990).
|
| Gender – Male (M) | CheckBox |
Check this box if you identify your gender as male (M) on your U.S. passport application.
|
| Gender – Female | CheckBox |
Select this checkbox if your gender is female.
|
| Gender – Female | CheckBox |
Check this box if you identify as female and want your passport to reflect that gender.
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| Changing gender marker – Yes | CheckBox |
Check this box if you are requesting to change the gender marker on your U.S. passport (e.g., from your previously recorded gender) and will provide the required supporting documentation.
|
| Place of Birth | Text |
Enter the city & state (if in the U.S.) or the city & country (if abroad) where you were born.
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| Social Security Number – First Group | Text |
Enter the first three digits of your nine-digit U.S. Social Security Number.
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| Social Security Number – Second Group | Text |
Enter the middle two digits of your Social Security Number.
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| Social Security Number – Third Group | Text |
Enter the last four digits of your Social Security Number.
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| Physical Characteristics | ||
| Height | Text |
Provide your height in feet and inches (e.g., 5’11”).
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| Hair Color | Text |
State your natural hair color (e.g., Brown, Black, Blonde).
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| Eye Color | Text |
State your natural eye color (e.g., Blue, Green, Brown).
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| Spouse Information | ||
| Current or Most Recent Spouse – Full Name | Text |
If you have ever been married, enter the full name (last, first, middle) of your current spouse or your most recent spouse.
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| Spouse – Date of Birth | Text |
Enter your spouse’s date of birth in MM/DD/YYYY format.
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| Spouse – Place of Birth | Text |
Provide the city and state (if in the U.S.) or city and country where your spouse was born.
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| Section 11, Spouse U.S. Citizen? – Yes | CheckBox |
Check this box if your current or most recent spouse is a citizen of the United States.
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| Row 11 – ‘No’ response to “Have you ever been married?” | CheckBox |
Check this box if you have never been married.
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| Travel Information | ||
| Departure Date (Travel Plans) | Text |
If you have upcoming travel, enter the planned departure date in MM/DD/YYYY format. Write “NONE” if you have no plans.
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| Return Date (Travel Plans) | Text |
If you have upcoming travel, enter the planned return date in MM/DD/YYYY format. Write “NONE” if you have no plans.
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| Countries to be Visited | Text |
List the countries you intend to visit on your next trip. Separate multiple countries with commas.
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