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E THE APPLICATION IN THE DESIGNATED AREA BELOW I declare under penalty of perjury all of the following: 1) I am a citizen or non-citizen national of the Untied States and have not. since acquiring U.S. citizenship or nationality. performed any of the acts listed under "Acts or Conditions' on page four of the instr

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

Floor. In Care Of or Attention if applicable. (e.g. In Care Of - Jane Doe. Apt # 100 City NEW YORK State Zip Code NY 10021 Country. if outside the United Slates 9. List all other names you have used. (Examples: Birth Name. Maiden. Previous Marriage. Legal Name Change. Attach additional pages if needed) A B.

U.S. PASSPORT RENEWAL APPLICATION FOR ELIGIBLE INDIVIDUALS Date of Application: CAN I USE THIS FORM? Complete the checklist to determine your eligibility to use this form I can su