1985 5. Alias(es) 8. Passport Number 11. Social Security Number (Middle) 4. Country of Citizenship 6. Gender (check one) 7. Alien Number (A#) El Male ❑x Female A 9. Country of Issuance 10. Expiration Date (mo., day, yr.) 08/04/2020 s 05/14/2025 Part B: Requesting Agency Information 'Note: Th