Please initial next to each of the requirements below.
DS-4085 Passport Pages Application (Online Only)
Complete and sign the DS-4085 Passport Pages application ONLINE (only). At the end, click "Create Form". The newly created application will have two barcodes, one on the left and another on the bottom right. Both barcodes must be present. DO NOT FORGET TO SIGN AND DATE the application.(sign in blue or black ink)
Print one copy of your travel itinerary, business letter or other intent to travel.
Passport must be in good condition. It will not be accepted if damaged or mutilated. NOTE: Your passport must have more than one year of validity left to qualify for additional pages.
A check or money order made payable to the "US Department of State" in the amount of $142.00. Temporary or starter checks will not be accepted. Note: Make sure that you spell out the check amount in the proper format (One Hundred Forty-two and 00/100).
All checks submitted must include a pre-printed address (sign in blue or black ink)
Print and sign one copy of the authorization letter. This allows us to act as an agent on your behalf. This will be emailed to you by your passport specialist by calling 866-895-9137 when it is confirmed that you have all required documentation. (sign blue or black ink only)
OVERNIGHT Shipping Label
Please only use OUR Shipping Label. It will be emailed to you by our Passport Specialist when you have completed this checklist. Fold label in half and place on outside of envelope. NOTE: call 877-503-9838 Option 0 for any problems printing your label
I hereby certify that I have preformed the above requirements to the best of my ability.
I understand that the U.S. Department of State could suspend my case in the event that my package is incomplete.