A PHP Error was encountered

Severity: Warning

Message: fopen(/var/lib/php/sessions/ci_sessione950ba5fca89241b800e969dcf3bb5f393e85221): failed to open stream: No space left on device

Filename: drivers/Session_files_driver.php

Line Number: 156

Backtrace:

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: _error_handler

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/Breadcrumbs/ErrorHandler.php
Line: 36
Function: handleError

File: /var/www/passport-usa.org/application/vendor/sentry/sentry/lib/Raven/ErrorHandler.php
Line: 111
Function: handleError

File: /var/www/passport-usa.org/application/core/MY_Controller.php
Line: 16
Function: __construct

File: /var/www/passport-usa.org/application/controllers/Form.php
Line: 7
Function: __construct

File: /var/www/passport-usa.org/index.php
Line: 316
Function: require_once


Warning: session_start(): Cannot send session cache limiter - headers already sent (output started at /var/www/passport-usa.org/system/core/Exceptions.php:272) in /var/www/passport-usa.org/system/libraries/Session/Session.php on line 140
Passport Lost or Stolen Form - Passport-USA

Document Editing & Management Service Tailored for Passport Forms

About the Applicant


Note: The large book option is for those who frequently travel abroad during the passport validity period, and is recommended for applicants who have previously required the addition of visa pages. *


Note: (City & State if in the U.S., or City & Country as it is presently known.)


Feet: Inches:

Are you known by other names?

Next

Contact Information

Where should the passport be mailed?

Note: Please complete this section with a mailing address even if you are picking up your new passport directly from a passport agency.



Please Enter your Permanent Address below:

Preferred Method of Communication




Your Email Address


Your Phone Number


Additional Phone Number




Next Back

Travel Plans

Please complete this section with known or anticipated travel plans.

Note: If you are traveling within two weeks, do not mail in your passport application. If you do, your application may not be completed before your travel date. Please call the National Passport Information Center at 1-877-487-2778 (TDD: 1-888-874-7793) to make an appointment to appear in person at a Passport Agency and receive expedited processing. The automated appointment system is available twenty-four hours a day, seven days a week

Next Back

Who should we contact in case of an emergency?

Next Back

Your Most Recent Passport




Passport Book

The date your most recent passport book was issued

Your name as printed on your most recent book:

Passport Card

The date your most recent passport book was issued

Your name as printed on your most recent card:


Next Back

Lost Or Stolen Passport Information

MINORS - If you are reporting a lost or stolen passport for a minor (persons under the age of 16), a parent or guardian must sign and mail-in a paper DS-64 Statement Regarding Lost or Stolen Passport.







I, the undersigned, declare under penalty of perjury all of the following: 1) That I have read and understood the warning on page one of this form; 2) The information furnished herein is correct and complete; 3) I have not given my U.S. passport book and/or passport card to another person or disposed of it in an unauthorized manner; 4) I understand that the U.S. passport(s) I report as missing will be invalidated and cannot be used; and 5) if I subsequently find and recover it, I will immediately return the passport and/or passport card to Passport Services at the address on page one of this form or to the nearest U.S. passport agency, U.S. embassy, or U.S. consulate abroad.


{{form.form['signature_2']}}
{{form.form['signature_3']}}
Next Back

Applicant's Parent & Spouse Information

Note: Please fill in as much information as you know. If completing as a third party or parent of minor, complete the form in the context of the applicant not yourself.

Mother/Father/Parent Of Applicant      Unknown



Mother/Father/Parent Of Applicant      Unknown



Spouse Of Applicant




Next Back

Personal Application Review

Review the data below and make edits if needed

Edit
Name Provided:
{{form.form['fullname']}}
Date Of Birth:
{{form.form['date_birth']}}
Place Of Birth:
{{form.form['city_birth_state']}}
Social Security Number:
{{form.form['ssn']}}
Sex:
Male
Female
Height:
{{form.form['height']}}
Hair Color:
{{form.form['hair_color']}}
Eye Color:
{{form.form['eye_color']}}
Occupation:
{{form.form['occupation']}}
Employer:
{{form.form['employer']}}
Edit
Mailing Street Address:
{{form.form['st_addr_1']}}
Mailing Street Address 2:
{{form.form['st_addr_2']}}
City:
{{form.form['addr_city']}}
State:
{{form.form['addr_state']}}
Zip Code:
{{form.form['addr_zip']}}
Country:
{{form.form['addr_country']}}
Edit
Permanent Address Same As Mailing Address:
No
Yes
Permanent Street Address:
{{form.form['p_addr_1']}}
Apartment Number:
{{form.form['p_apt']}}
City:
{{form.form['p_addr_city']}}
State:
{{form.form['p_addr_state']}}
Zip Code:
{{form.form['p_addr_zip']}}
Country:
{{form.form['p_addr_country']}}
Edit
Email Address:
{{form.form['email']}}
Home Phone:
{{form.form['phone']}}
Edit
Date Of Trip:
{{form.form['trip_date']}}
Return Date from Trip:
{{form.form['date_return']}}
Countries To Be Visited:
{{form.form['country_visit']}}
Edit
Emergency Contact:
{{form.form['emergency_name']}}
Relationship:
{{form.form['emergency_relationship']}}
Street Address :
{{form.form['emergency_street']}}
Apartment Number:
{{form.form['emergency_apt']}}
City:
{{form.form['emergency_city']}}
State:
{{form.form['emergency_state']}}
Zip Code:
{{form.form['emergency_zipcode']}}
Contact Phone:
{{form.form['emergency_tel']}}
Edit
Have Passport Book:
Yes
No
Name On Previous Passport Book:
{{form.form['book_fname']}}
Previous Passport Book Number:
{{form.form['book_number']}}
Book Issuance Date:
{{form.form['book_issued']}}
Book Still In Possession:
Yes
No
Edit
Have Passport Card:
Yes
No
Name On Previous Passport Card:
{{form.form['card_fname']}}
Previous Passport Card Number:
{{form.form['card_number']}}
Card Issuance Date:
{{form.form['card_issued']}}
Card Still In Possession:
Yes
No
Data Printed Incorrectly:
Yes, it was printed correctly
No, it was printed incorrectly on my passport book
Name Changed Since Document Issued:
Yes, it has changed since I got my passport book
No, it has not changed since I was issued a document
Passport Book Limited For One Year Or Less:
Yes
No
First Name Printed Incorrectly:
Yes
No
Middle Name Printed Incorrectly:
Yes
No
Last Name Printed Incorrectly:
Yes
No
Place Of Birth Printed Incorrectly:
Yes
No
Date Of Birth Printed Incorrectly:
Yes
No
Sex Printed Incorrectly:
Yes
No
Reason For Name Change:
Marriage
Court
Date Of Name Change:
{{form.form['date_change']}}
Place Of Name Change:
{{form.form['place_change']}}
Edit
Name Of Mother/Father/Parent:
Unknown
{{form.form['parent_1_fname']}} {{form.form['parent_1_lname']}}
Mother/Father/Parent Date Of Birth:
{{form.form['parent_1_date_birth']}}
Mother/Father/Parent Place Of Birth:
{{form.form['parent_1_place_birth']}}
Mother/Father/Parent Sex:
Male
Female
Mother/Father/Parent U.S. Citizen:
Yes
No


Name Of Mother/Father/Parent:
Unknown
{{form.form['parent_2_fname']}} {{form.form['parent_2_lname']}}
Mother/Father/Parent Date Of Birth:
{{form.form['parent_2_date_birth']}}
Mother/Father/Parent Place Of Birth:
{{form.form['parent_2_place_birth']}}
Mother/Father/Parent Sex:
Male
Female
Mother/Father/Parent U.S. Citizen:
Yes
No
Married:
Yes
No
Name Of Spouse:
{{form.form['spouse_name']}}
Spouse Date Of Birth:
{{form.form['spouse_dob']}}
Spouse Place Of Birth:
{{form.form['spouse_place_birth']}}
Spouse U.S. Citizen:
Yes
Date Of Most Recent Marriage:
{{form.form['spouse_date_marriage']}}
Widowed or Divorced:
Yes
No
Widowed or Divorced Date:
{{form.form['divorced_date']}}
Preview Back Back
Passport-USA is a private company that assists its clients in the preparation and completion of passport application forms prior to submission to an official U.S. Passport Agency. Passport-usa.org is not affiliated with the U.S. Department of State or any government agency. Blank Passport forms and instructions can be provided for free from travel.state.gov. However, this will not benefit from the simplified PDF editor and error checking services provided by Passport-usa.org. We do not review the information you submit on a legal stance or any other professional standpoint. We are not a government approved agency. We do not provide legal advice, and are not a substitute for an attorney. If legal services are required in this regard, clients are advised to seek out a qualified and practicing legal advice. All forms that can be completed online using our service are available as blank forms with written instructions for free from the U.S. State Department. Passport-USA's fee does not include any government application, biometric, or filing fees. Access to and use of Passport-usa.org website is subject to Passport-USA's Terms of Service and Privacy Policy. If your prepared application is not accepted for any reason, we will refund all our fees. You may visit the U.S. Department of State and download free forms by clicking here.
Copyright © 2025

Warning: session_write_close(): Failed to write session data (user). Please verify that the current setting of session.save_path is correct (/var/lib/php/sessions) in Unknown on line 0