United States Department of State Passport Services ...

[Pages:1]United States Department of State Passport Services

REQUEST FOR FILE SEARCH AND VERIFICATION OF U.S. CITIZENSHIP

Last Name: First and Middle Name(s):

Date and Place of Birth:

Select the Document for Which You are Submitting This Request

Passport Book

Passport Card

Consular Report of Birth Abroad

Passports Only

Name as Listed in Document: Date of Issue:

Date of Expiration: Passport Number:

Endorsement(s):

I hereby request Passport Services to initiate a file search to verify that I have been issued a U.S. Passport or that a Consular Report of Birth Abroad was filed for me. I agree to pay the

applicable fee for this service. I understand that this service is performed solely for issuance of a passport under urgent circumstances and I will not receive a copy of my previous passport or

Consular Report of Birth Abroad.

Signature:

Date:

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