Damaged Passport Checklist

Please print this checklist to make sure you include and send all items listed here to APVI.

DS-11 Application for a New Passport
Statement of Damaged Passport
Mutilated Passport
Proof of US Citizenship
Proof of Identity
Proof of Travel
One Passport Photo
Government Fees
Previously Issued US Passport Card (If applicable)
Letter of Authorization
Signed Checklist
* By signing this checklist, I agree that all items within this application are completed per the instructions provided to me by my APVI specialist. I understand that if any part of my application is missing or incorrect, I will need to provide the additional documentation at my own cost.
Signature