Lost or Stolen Passport DS-64

"*" indicates required fields

1Applicant Details

2Contact Information

3Travel Plans

4Emergency Contact

5Passport Details

6Lost/Stolen Information

7Parents and Spouse

8Order Summary

9Preview Details

1. Applicant Details

Do you need a regular or large passport book?*

Regular Book (Standard)

Large Book (Non-Standard)

The large book is for frequent travelers who need more visa pages.

Applicant's Name*

First Name Middle Name Last Name

Date of birth*

City of Birth*

Country of Birth*

State/Territory of Birth*

Sex*

Social Security Number*

If you haven’t been issued your SSN yet, simply enter zeros in this field.

Occupation*

Employer or School (Optional)

Height*

Inches*

Eye Color*

Hair Color*

List all other names you have used.

(Examples: Birth Name, Maiden, Previous Marriage, Legal Name Change. Attach additional pages if needed.)

Yes

Former Name A

Former Name B

5. Passport Details

Have you ever been issued any of the following documents?*

U.S. Passport Book

U.S. Passport Card

Both

The U.S. passport card is not valid for international air travel.

Was your passport book lost or stolen?*

Was your passport book lost or stolen?

Lost

Stolen

Date

Most recent passport book issue date (Optional)

Name as printed on your most recent passport book

Name as printed on your most recent passport book (Optional)

First Name Last Name

Book Number

Book Number (Optional)

Was your passport card lost or stolen?*

Was your passport card lost or stolen?

Lost

Stolen

Date

Most recent passport card issue date (Optional)

Name as printed on your most recent passport card

Name as printed on your most recent passport card (Optional)

First Name Last Name

Card Number

Card Number (Optional)