DS-5504 Fillable PDF – Name Change, Data Correction & Limited Passport Replacement

The DS-5504 is the official U.S. Department of State application used when you need to change the name on a passport, correct a printing error, or replace a limited‑validity passport. With Formize’s fillable PDF tool you can complete the form online, avoid manual errors, and print a clean copy ready for submission.

What Is the DS-5504 Form?

DS-5504 is designed for three specific situations:

• Name change – if your legal name changed within one year of your last passport issuance.
• Data correction – to fix a typo or incorrect personal information on an existing passport.
• Limited passport replacement – when a temporary or limited‑validity passport expires or is damaged.

How to Fill Out DS-5504 with Formize

Instead of downloading the PDF and opening a separate editor, simply click the “Fill out this form” button on this page. The Formize PDF Filler app loads in your browser, letting you:

1. Enter personal details directly into interactive fields.
2. Upload a passport‑style photo.
3. Save a draft and return later if needed.
4. Download the completed, printable PDF with one click.

Common Mistakes to Avoid

• Using a name change older than one year – the form will be rejected.
• Leaving the signature line blank or signing on the wrong page.
• Submitting an incorrect passport number or expiration date.
• Forgetting to attach the required supporting documents (photo, legal name‑change proof, etc.).

Required Supporting Documents

Depending on your request, you will need to include:

• Current valid U.S. passport (or limited‑validity passport).
• One recent color passport photo (2" x 2").
• Legal name‑change documentation (marriage certificate, court order) – if applicable.
• Proof of the printing error (e.g., a copy of the original passport showing the mistake).

Where to Submit Your Completed Form

After printing, mail the DS-5504 package to the address listed in the form’s instructions or bring it to a regional passport agency. The application is free of charge; expedited processing is available for a fee.

Need help? Review the official DS‑5504 PDF for detailed instructions.