Statement Regarding a Lost or Stolen U.S. Passport Book and/or Card

OMB 1405-0014

This form is used in conjunction with a DS-11, "Application for a U.S. Passport", or submitted separately to report loss or theft of a U.S. passport. Passport Services collects the information when a U.S. citizen or non-citizen national applies for a new U.S. passport and has been issued a previous, still valid U.S. passport that has been lost or stolen, or when a passport holder independently reports it lost or stolen. Passport applicants can either download the form from the internet or obtain one at any Passport Agency or Acceptance Facility.

The latest form for Statement Regarding a Lost or Stolen U.S. Passport Book and/or Card expires 2021-11-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Legal Authorities.docx Supplementary Document
Form DS-64_OMB No 1405-0014_PRA Supporting Statement.docx Supporting Statement A
Statement Regarding a Lost or Stolen U.S. Passport Book and/or Card Other-Web Application for DS-64

All Historical Document Collections

202109-1405-001 Approved without change	Revision of a currently approved collection	2021-09-10
201807-1405-004 Approved without change	Reinstatement with change of a previously approved collection	2018-07-19
201711-1405-004 Approved with change	No material or nonsubstantive change to a currently approved collection	2017-11-08
201507-1405-004 Improperly submitted and continue	No material or nonsubstantive change to a currently approved collection	2015-07-30
201505-1405-002 Approved without change	Extension without change of a currently approved collection	2015-05-26
201303-1405-003 Approved with change	Revision of a currently approved collection	2013-03-13
201103-1405-005 Approved with change	Extension without change of a currently approved collection	2011-03-16
200902-1405-001 Approved without change	Revision of a currently approved collection	2009-02-11
200807-1405-010 Approved without change	No material or nonsubstantive change to a currently approved collection	2008-08-04
200511-1405-001 Approved without change	Revision of a currently approved collection	2005-11-21
200210-1405-003 Approved without change	Extension without change of a currently approved collection	2002-10-11
200109-1405-002 Approved without change	Reinstatement with change of a previously approved collection	2001-09-07
199712-1405-003 Approved without change	Reinstatement without change of a previously approved collection	1997-12-31
199409-1405-004 Approved without change	Reinstatement with change of a previously approved collection	1994-09-27
199108-1405-004 Approved without change	Reinstatement with change of a previously approved collection	1991-08-01
198408-1405-001 Approved without change	Reinstatement with change of a previously approved collection	1984-08-14
198107-1405-002 Approved with change	No material or nonsubstantive change to a currently approved collection	1981-07-17
197902-1405-001 Approved without change	Reinstatement without change of a previously approved collection	1979-02-14
197812-1405-002 Approved without change	Reinstatement without change of a previously approved collection	1978-12-31
197307-1405-001 Approved with change	No material or nonsubstantive change to a currently approved collection	1973-07-25