Completing the DS-5504

The form should be downloaded and printed on white A4 or letter-size paper, with each page on a separate sheet of paper.

The instructions on this form are written for individuals applying for a passport within the United States. As applications are processed differently outside the United States, you should ignore instruction pages one and two of this form.

Complete the form in block letters and black ink. Parents should sign the form for children under age 16.

Item 1 – Name of Applicant: If you have changed your name since your most recent passport was issued, please complete this item with your new name.

Item 5 – Social Security Number: You must complete this item. Failure to provide a Social Security Number if you have been issued one can result in a $500 fine enforced by the IRS. If you have never had a Social Security Number (SSN), write zeros in the boxes. If you have a number, but do not remember it, call the Embassy’s Federal Benefits Unit in Manila, Philippines for assistance. You may call 001-632-301-2000, ext. 9; Mondays to Fridays 8:00 a.m. – 1:00 p.m. (Hong Kong, Macau and Manila are in the same time zone.)

Item 6 – Mailing Address: Complete this item with a Hong Kong or Macau address, either your home address or the address where you are staying. Please note that you may choose to have your passport sent to a different address when you complete your self-addressed envelope.

Item 7 – Contact Phone Number: Please provide a local Hong Kong or Macau telephone number so that we can contact you if we have any questions about your application.

Item 17 – Permanent Address or Residence: Complete this item with any address you consider to be your permanent address. This need not be in the Hong Kong, Macau or the U.S.

Items 18 and 19 – Emergency Contact and Travel Plans: This information is not required, but may be helpful in processing your application and in assisting you in the future.

Oath & Signature: You must read the “Acts or Conditions” on page four of the instruction pages of this form before you sign. If any mentioned acts or conditions have been performed by or apply to the applicant, cross out only the applicable portion(s) and submit an explanatory signed statement with the application.


Last modified: August 15, 2012