DS-4085 Passport Pages Application
Complete the DS-4085. Form must be completely filled out do not leave anything blank.
Print two authorization letters. This allows us to act as an agent on your behalf. Must be signed by applicant ages 16 and over. The parent coming in must sign for child 15 years of age and under.
Must be signed by applicant ages 16 and over. The parent coming in must sign for child 15 years of age and under.
If available, provide an International ticket, e-ticket, itinerary or hotel confirmation for those driving. If traveling on business and no itinerary is available, a letter, signed by someone at the company, on company letterhead, which indicates the dates, location, name of person traveling and purpose of travel will suffice.
Passport must be in good condition. It will not be accepted if damaged or mutilated. Lamination must not be peeling off of the photo page of the passport.
A personal check or money order made payable to the "U.S. Department of State" in the amount of $142.00. Temporary / starter checks or checks without name and address will NOT be accepted.
This form is used for Rushpassport.com to keep track of your application.
Call us before coming in personally or sending via Fedex for updated fees.
Note: Cash or Credit Card (Visa, Master Card, Amex) Accepted. Credit Card Authorization Form