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DS-5520 06-2013 Page 1 of 3 U.S. Department of State OMB Approval No. 1405-xxxx Expiration Date xx-xx-xxxx Estimated Burden 45 minutes Section A Biographical Information 1. SUPPLEMENTAL QUESTIONNAIRE TO DETERMINE IDENTITY FOR A U*S* PASSPORT USE OF SUPPLEMENTAL QUESTIONNAIRE TO DETERMINE IDENTITY FOR A U*S* PASSPORT This form is intended to supplement an application for a U*S* passport in the event insufficient evidence of identity is provided* In addition to completing this form you may be asked to provide further documentary evidence to support your identity claim* Documentary evidence should contain your full name/photograph with issue date or full name/signature with issue date. For more information on proof of identity please refer to page two of the instructions for the DS-11 Application for a U*S* Passport or visit travel*state. gov* FORM INSTRUCTIONS 1. To assist us in establishing your identity for a U*S* passport please fill out this supplemental questionnaire and return it to the requesting passport office. If you have been asked for additional information and/or documentation please submit the information and/or documentation requested with this supplemental questionnaire. 2. If you are unable to provide primary evidence of identity such as a previously issued U*S* passport naturalization certificate valid driver s license valid government-issued identification or another form of primary evidence of identity please submit secondary evidence. For lists of primary and secondary evidence of identity go to http //travel*state. gov/passport and click on the link to information for first time applicants. 3. Please complete the questions on this form to the best of your knowledge. Generally the more information you are able to provide the faster we may be able to process your U*S* passport application* 4. If you are unsure of the answer to a question please provide a response to the best of your knowledge. For example if you are unsure of an exact address please provide the city state and street name if you can recall them* Passport Services will consider all the information derived from the form in its entirety. 5. Failure to answer every question will not necessarily preclude passport issuance as the form is considered in its entirety. 6. If you have no knowledge of the answer to a question please write I don t know. If you believe a particular question does not apply to you or your circumstances please write not applicable or N/A. 7. If you need more space to respond to a question please write the rest of your response on a separate sheet of paper. FOR INFORMATION AND/OR QUESTIONS Please visit our website at travel*state. gov* In addition contact the National Passport Information Center NPIC toll-free at 1-877-487-2778 TDD 1-888-874-7793 or by e-mail at NPIC state. gov* Customer Service Representatives are available Monday-Friday 8 00 a*m*-10 00 p*m* Eastern Time excluding federal holidays. Automated information is available 24/7. WARNING False statements made knowingly and willfully in passport applications or in affidavits or other supporting documents submitted therewith are punishable by fine and/or imprisonment under the provisions of 18 U*S*C.

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