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DS-5504 2025 free printable template

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This form is used by U.S. passport holders to apply for a name change or correction on their passport issued within the last year, or for a limited passport replacement.
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Who needs a DS-5504 form?

An eligible individual who wants to apply for a US passport should complete this form. An eligible individual is a US citizen who has changed their name and the US passport was issued less than one year ago; the information in their previous passport was incorrect; or the previous US passport was limited in validity and issued less than one year ago.

What is the purpose of the DS-5504 form?

This form provides the personal information about the applicant which is required to issue a US passport. The US passport exists in card and book format. The passport in card format is not valid for international air travel.

What documents must accompany the DS-5504 form?

The application for US passport should be accompanied by the most recent US passport; a recent color photograph (the photo requirements are listed on the second page of the form); evidence to support a name change (birth certificate or marriage certificate) or other data change. All the supporting documents (except the photos) will be returned to the applicant.

When is the DS-5504 form due?

This application is completed when there is a need. The estimated time for completing the form is 60 minutes.

What information should be provided in the DS-5504 form?

The application asks for the following details from the applicant:

  • Type of the required document (Passport book, Passport Card, Both)
  • Applicant’s name
  • Applicant’s date and place of birth
  • Applicant’s social security number
  • Mailing address
  • Passport book and/or passport card information
  • Applicant’s appearance (height, hair color, eye color)
  • Occupation
  • Employer or school
  • Emergency contact
  • Travel plans
  • Reason of applying for a new passport

The applicant should also sign and date the form.

What do I do with the application after the completion?

The completed form is forwarded to National Passport Processing Center, Philadelphia, PA.

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People Also Ask about ds 5504 fillable online form

If you are eligible, you may use form DS-82 and send in your renewal application by mail. If you are not eligible to send in the application by mail, you must use form DS-11 and apply in person. If you are making a change or correction, you may use form DS-5504.
If you are eligible, you may use form DS-82 and send in your renewal application by mail. If you are not eligible to send in the application by mail, you must use form DS-11 and apply in person. If you are making a change or correction, you may use form DS-5504.
You qualify to have your passport replaced using a DS-5504 form; this form can only be used to replace limited validity passports (emergency passports) and passports that had an error when they were printed within a year of its issue date.
How can I correct it? A: At the Passport Seva Kendra (PSK)/Post Office Passport Seva Kendra (POPSK) please ask the Citizen Service Executive (CSE) i.e. at Counter-A to make the required changes in the application form.
Submit the following by mail: Form DS-5504. Your most recent U.S. passport. Your original or certified name change document, such as a marriage certificate, divorce decree, or court order. One color passport photo.
Form DS-82 The DS-82 form or DS82 application for Passport Renewal is used when renewing a United States passport that is expired or near the expired date for no more than five (5) years beyond the expiration date on the passport.
Renewal of regular U.S. passport for an adult (DS-82 form)
You qualify to have your passport replaced using a DS-5504 form; this form can only be used to replace limited validity passports (emergency passports) and passports that had an error when they were printed within a year of its issue date.
DS-5504 04-2022. U.S. Department of State. APPLICATION FOR A U.S. PASSPORT FOR ELIGIBLE INDIVIDUALS. CORRECTION, NAME CHANGE TO PASSPORT ISSUED 1 YEAR AGO OR LESS, AND LIMITED PASSPORT REPLACEMENT. Please read all instructions first and type or print in black ink to complete this form.

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DS-5504 is the application form used to apply for a U.S. Passport Book or Passport Card for individuals who are eligible for a passport but need to renew their passport or correct information on a previously issued passport.
Individuals who are eligible to renew their passport by mail and meet specific criteria such as having been issued their passport within the last 15 years, being at least 16 years old at the time of filing, and having the same name or can legally document a name change.
To fill out DS-5504, applicants must provide personal information such as name, date of birth, and address, along with details about their previous passport, including its number and issue date. Instructions are provided on the form for specific sections and required documents.
The purpose of DS-5504 is to process applications for passport renewals or corrections in an efficient manner and to ensure the correct and updated passport information for U.S. citizens.
The information that must be reported on DS-5504 includes the applicant's personal identification details (name, date of birth, place of birth), previous passport information, current address, and any details regarding legal name changes if applicable.
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