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Form DS-64 PDF Template

What is a Form DS-64?

Form DS-64 is issued by the U.S. Department of State for reporting a lost or stolen U.S. passport book or card. This form is essential for ensuring that the missing passport is invalidated, preventing its misuse. Completing Form DS-64 initiates the process to report the passport's loss or theft, which is crucial for protecting your identity and securing the issuance of a new passport. The form can be submitted online, by mail, or by phone, and is often submitted alongside Form DS-11 when applying for a new passport.


How to Fill in Our Form DS-64 PDF Template

Follow these steps to fill in the Form DS-64 template:

  • Header Information: Include the OMB Control Number (1405-0014) and the Expiration Date.

  • Options to Report Loss/Theft:

    • Online: Visit travel.state.gov.

    • Phone: Call 1-877-487-2778 (TDD: 1-888-874-7793). Not available for customers abroad.

    • Mail: Submit the form and a photocopy of a government-issued photo ID to:

      • ATTN: CLASP, U.S. Department of State, CA/PPT/S/CLASP, 44132 Mercure Cir, P.O. Box 1227, Sterling, VA 20166-1227.

  • Important Notices:

    • False statements are punishable by law.

    • Providing accurate and truthful information is essential.

  • Privacy Act Statement:

    • Authorities and purposes for data collection.

    • Disclosure of Social Security number and other personal information is voluntary but may result in processing delays if not provided.

    • Routine uses of the information include law enforcement and fraud prevention.

  • Filling in Personal Information:

    • Personal Details: Last name, first name, middle name, date of birth, place of birth, Social Security number, current address, telephone number, and email address.

    • Passport Details: Select the type of document (passport book or card) and its status (lost or stolen).

    • Application Connection: Indicate if the form is submitted in connection with a new passport application.

    • Name Change: If applicable, state the previous name under which the lost or stolen passport was issued.

  • Incident Details:

    • Explanation: Describe how the passport was lost or stolen.

    • Location: Provide the address where the loss or theft occurred.

    • Date: Specify the date when the passport was lost or stolen or the last known date it was in your possession.

    • Police Report: Indicate if a police report was filed and attach a copy if available.

  • Additional Passports: List any other valid U.S. passports that have been lost or stolen, including approximate dates and numbers if known.

  • Signatures:

    • Applicant's Signature: Sign and date the form.

    • Parent/Guardian Signatures: If the applicant is under 16, both parents or guardians must sign and provide ID photocopies. If only one parent has sole authority, include supporting documentation.

  • Final Steps:

    • Print legibly or type in black ink.

    • Submit the completed form to the appropriate address or as instructed online or by phone.

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