Form DS-82, U.S. Passport Renewal Application for Eligible Individuals Completed Form Examples and Samples

View detailed examples and samples of a completed Form DS-82, U.S. Passport Renewal Application for Eligible Individuals. Our guide provides filled-out DS-82 forms, including scenarios like name changes, to help you accurately complete your application and avoid common mistakes.
Form DS-82, U.S. Passport Renewal Application for Eligible Individuals has a moderate Form Complexity Index of 62/100 — Instafill’s AI completes it in under a minute.
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Completed Form DS-82 sample for a U.S. passport renewal application with a legal name change due to marriage.

Form DS-82 Example – Passport Renewal with Name Change

How this form was filled:

This sample DS-82 form illustrates how to complete the application for an adult renewing their U.S. passport who has also had a legal name change due to marriage. It correctly populates personal details, information from the most recent passport, and specifies the name change, referencing the required legal documentation (a marriage certificate). The application is for both a passport book and card, signed and dated for the year 2026.

Information used to fill out the document:

  • Applicant's Current Name: Jane Emily Smith
  • Applicant's Previous Name: Jane Emily Doe
  • Reason for Name Change: Marriage
  • Date of Birth: 08/15/1990
  • Place of Birth: New York, U.S.A.
  • Social Security Number (Last 4): 6789
  • Mailing Address: 123 Main Street, Anytown, VA 12345
  • Most Recent Passport Number: P123456789
  • Most Recent Passport Issue Date: 06/01/2016
  • Application Product: Passport Book & Card
  • Travel Plans: France, Italy in August 2026
  • Emergency Contact: John Smith (Spouse)
  • Signature Date: 05/15/2026

What this filled form sample shows:

  • Accurate completion of personal information including current and previous names.
  • Properly indicates a name change due to marriage and includes details of the supporting legal document.
  • Correctly fills out the most recent U.S. passport information section, a key eligibility requirement.
  • Selection of both Passport Book and Card for renewal.
  • Completed with a recent signature and date for the year 2026.

Form specifications and details:

Form Name: Form DS-82, U.S. Passport Renewal Application for Eligible Individuals
Use Case: Standard passport renewal with a legal name change due to marriage.
Eligibility Highlight: Applicant's most recent passport was issued less than 15 years ago when they were age 16 or older.
Categories: individual application forms, passport forms
Created: February 03, 2026 05:00 AM
Completed Form DS-82 sample for a U.S. passport renewal application with a legal name change due to marriage.