U.S. Department of State
OMB Control No. 1405-0014
Expiration Date:
Estimated Burden: 5 Minutes
Page 1 of 2
DS-64
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To report a valid lost or stolen passportERRNDQGRUFDUG please choose ONE of the following options:
1. ONLINE:Visit our website at travel.state.gov.
OR
OR
3. BY PHONE:Call 1-877-487-2778 (TDD: 1-888-874-7793) and follow the representative's instructions.This option is not
available for customers abroad.
OR
4. BY MAIL:Submit this form AND a front and back photocopy of a government-issued photo identification (such as a driver's
license or state-issued identification) to the following address ONLY IF you are NOT applying for a new U.S.
passport bookand/or card:
ATTN: CLASP
U.S. Department of State
CA/PPT/S/50&/$63
44132 Mercure Cir
P.O. Box 1227
Sterling, VA 20166-1227
* Only use this address to submit this form or other correspondence about lost/stolen passports. For general inquiries, call the
National Passport Information Center at 1-877-487-2778.
Protect yourself against identity theft! Report a lost or stolen U.S. passport!
For more information, please visit our website: travel.state.gov
:$51,1*
False statements made knowingly and willfully on this form, in U.S. passport applications, or in affidavits or other supporting
documents submitted therewith are punishable by fine and/or imprisonment under U.S. law, including the provisions of 18 U.S.C.
1001 and/or 18 U.S.C. 1542. Alteration or mutilation of a U.S. passport is punishable by fine and/or imprisonment under the
provisions of 18 U.S.C. 1543.The use of a U.S. passport in violation of the restrictions contained therein or of the passport
regulations is punishable by fine and/or imprisonment under 18 U.S.C. 1544. All statements and documents submitted are subject to
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AUTHORITIES:We are authorized to collect this information by 22 U.S.C. 211a et seq.; 8 U.S.C. 1104; 8 U.S.C. 1737; Executive
Order 11295 (August 5, 1966); and 22 C.F.R. Parts 50 and 51.
PURPOSE:7he information UHTXHVWHGRQWKLVIRUPLVXVHGto ensure that no one has more than one valid U.S. passport book
DQGRQHYDOLG86passport card at any one time, except as authorized by the U.S. Department of State, and to combat passport
IUDXGDQGPLVXVH7he collection of the Social Security number will be used to verify the identity of the person reporting the lost
RUVWROHQSDVVSRUWDQGto identify the passport being reported lost or stolen. There is no other purpose unless authorized by law.
DISCLOSURE: Providing your Social Security number and other information on this form is voluntary, but failure to provide the
information on this form may, given the form's purpose of verification of your identity, result in processing delays.
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Public reporting burden for this collection of information is estimated to average five minutes per response, including time required
for searching existing data sources, gathering the necessary data, providing the information and/or documents required, and
reviewing the final collection. You do not have to supply this information unless this collection displays a currently valid OMB control
number. If you have comments on the accuracy of this burden estimate and/or recommendations for reducing it, please send them
to: 3DVVSRUW)RUPV2IILFHUU.S. Department of State, Bureau of Consular Affairs, Passport Services, Office of Program Management
DQG2SHUDWLRQDOSupport, 44132 Mercure Cir., P.O. Box 1199, Sterling, VA 20166-1199.
5287,1(86(67KLVLQIRUPDWLRQPD\EHGLVFORVHGWRDQRWKHUGRPHVWLFJRYHUQPHQWDJHQF\DSULYDWHFRQWUDFWRUDIRUHLJQJRYHUQPHQW
DJHQF\RUWRDSULYDWHSHUVRQRUSULYDWHHPSOR\HULQDFFRUGDQFHZLWKFHUWDLQDSSURYHGURXWLQHXVHV7KHVHURXWLQHXVHVLQFOXGHEXWDUH
QRWOLPLWHGWRODZHQIRUFHPHQWDFWLYLWLHVHPSOR\PHQWYHULILFDWLRQIUDXGSUHYHQWLRQERUGHUVHFXULW\FRXQWHUWHUURULVPOLWLJDWLRQDFWLYLWLHV
DQGDFWLYLWLHVWKDWPHHWWKH6HFUHWDU\RI6WDWHVUHVSRQVLELOLW\WRSURWHFW86FLWL]HQVDQGQRQFLWL]HQQDWLRQDOVDEURDG)RUDPRUHGHWDLOHG
OLVWLQJRIWKHURXWLQHXVHVWRZKLFKWKLVLQIRUPDWLRQPD\EHSXWSOHDVHVHHWKH'HSDUWPHQWRI6WDWHV3UHIDWRU\6WDWHPHQWRI5RXWLQH8VHV
3XEOLF1RWLFHRI-XO\DQGWKHOLVWLQJRIURXWLQHXVHVVHWIRUWKLQWKH6\VWHPRI5HFRUGV1RWLFHVIRU2YHUVHDV&LWL]HQ
6HUYLFHV5HFRUGVDQG2WKHU2YHUVHDV5HFRUGV6WDWHDQG3DVVSRUW5HFRUGV6WDWH
STATEMENT REGARDING A VALID LOST OR STOLEN U.S. PASSPORT BOOK AND/OR CARD
,I\RXUPRVWUHFHQWORVWRUVWROHQSDVVSRUWLVH[SLUHGLWLVQRORQJHUYDOLGDQG\RXGRQRWQHHGWRVXEPLWWKLVIRUP
2.
WHILE APPLYING FOR A
NEW U.S. PASSPORT:Submit this form with
a new DS-11, Application for DU.S.
Passport along ZLWK
required documentation to any designated acceptance facility,
U.S.
passport agency, U.S. embassy, or U.S. consulate abroad.