U.S. PASSPORT RENEWAL APPLICATION FOR ELIGIBLE INDIVIDUALS PLEASE DETACH AND RETAIN THIS INSTRUCTION SHEET FOR YOUR RECORDS Date of Application: CAN I USE THIS FORM? Complete the checklist to determine your eligibility to use this form I can submit my most recent U.S. passport book andor U.S. passport card with this application. X Yes No I at least 16 old my most recent U.S. book was years when passport and/or passport card was issued. X Yes No I was issued my most recent U.S. passport book andror passport card less than 15 years ago. X Yes K No My most recent U.S. passport book andror U.S. passport card that I am renewing has not been lost. stolen. mutilated. or damaged. X Yes No My U.S. passport has not been limited from the normal ten year validity period due to passport damagermutilation. multiple passport thefts/losses, or noncompliance with 22 C.F.R. 51.41. (Please X Yes No refer to the back pages of your U.S. passport book for endorsement information.) I use the same name as on my recent U.S. passport book andror U.S. passport card. Yes K No —OR— I have had my name changed by marriage or court order and can submit proper documentation to reflect my name change. If you answered NO to any of the statements above, STOP - You cannot use this form! You must apply on application form DS-11 by making a personal appearance before an acceptance agent authorized to accept passport applications. Visit travel.state.gov to find your nearest acceptance facility. U.S. PASSPORTS. EITHER IN BOOK OR CARD FORMAT. ARE ISSUED ONLY TO U.S. CITIZENS OR NON-CITIZEN NATIONALS. EACH PERSON MUST OBTAIN HIS OR HER OWN U.S. PASSPORT BOOK OR PASSPORT CARD. THE PASSPORT CARD IS A U.S. PASSPORT ISSUED IN CARD FORMAT. LIKE THE TRADITIONAL PASSPORT BOOK. IT REFLECTS THE BEARER'S ORIGIN. IDENTITY. AND NATIONALITY AND IS SUBJECT TO EXISTING PASSPORT LAWS AND REGULATIONS. UNLIKE THE PASSPORT BOOK. THE PASSPORT CARD IS VALID ONLY FOR ENTRY T