Complete FORM DS-5504 online, and print it out single-sided. Back to back printed forms cannot be processed. Do not print the instructions as you are to use this website instead.  At ‘Mailing Address’ list your Dutch address, even if it is only temporary.  You cannot currently list a “Country” when completing the “Emergency Contact” section on our forms. Please list an emergency contact in the United States.  You may sign the form at home.  For minors under 16, either parent/legal guardian may sign the form. Applications filled out by hand may require longer to process.

If your passport has the following endorsement in the back:

• This passport expires on (date) and is a replacement for a lost/stolen/damaged passport. A full validity replacement must be approved by the Department of State.

you do NOT qualify for a free replacement passport and you must follow the guidance for replacing a lost or stolen passport, minus the DS-64 and police report requirement.  It will be helpful to bring recovered passports, if any.

You must provide an answer to question no. 5, even if you do not have a Social Security Number or do not remember it.  Do NOT list your Dutch Burger Service Number (BSN). Click here to learn more about passports and the social security number requirement.

Provide your limited validity U.S. passport, with a photo copy of the biographical information page.

One U.S. format: 2″ x 2″ (5 x 5 cm.) passport photo, taken within the last six months. We cannot process the smaller Dutch format photos!  Click here for guidance on the perfect U.S. passport photo.  Make sure to watch the video.

Endorsement ‘Issued under 22 CFR 51.41’ (Code of Federal Regulations)

If the endorsement code on the last page of your emergency passport states that your passport was issued under ’22 CFR 51.41′, you must also submit proof of citizenship in the form of one of the following:

• a U.S. birth certificate;
• a Consular Report of Birth Abroad;
• a U.S. naturalization certificate;
• a U.S. certificate of citizenship;
• an expired U.S. passport.

Endorsement ‘Issued under 22 CFR 51.23’

If the endorsement code on the last page of your emergency passport states that your passport was issued under ’22 CFR 51.23′, you must also submit proof of identity in the form of one of the following:

• a valid passport of any country;
•  valid driver’s license with photograph;
• a national identity card with photograph;
• a valid U.S. or state issued ID card;
• a U.S. military identity card.

Aside from the original(s) provide a plain photocopy of your passport’s biographical information page and any supporting documents as applicable to your application.  Photocopies of the application form are not required.

When using Form DS-5504 to replace an emergency passport of a child under 16 years of age:

• Either parent/legal guardian may sign on the parent’s signature line.
• If one parent/legal guardian was not available to sign the original DS-11 form on which the emergency passport was issued, a photocopy of that parent/legal guardian’s identity document is required.

DO NOT MAIL YOUR PASSPORT TO THE UNITED STATES!

Mail your passport and application to:
U.S. Consulate General
U.S. Citizen Services – Mail-in
John Adams Park 1
2244 BZ  Wassenaar
The Netherlands

Provide a prepaid return envelope

• Size: approximately 23 x 16 centimeters or 9×6 inches – no bigger envelopes, no padded envelopes, no big DHL envelopes, please.
• On this envelope attach your DHL label*, or
• write the passport applicant’s name and address, and stick 5 x regular ‘1’ PostNL stamps in the top right corner.

We cannot send passports to addresses outside of the Netherlands.

*We recommend using the trackable “waybill” from DHL express, or DHL parcel label.  These you must order online at: https://my.dhlexpress.nl/pwa/shipment/package/.
When prompted, please select “Mailbox Parcel”, and enter your personal information as the recipient. Check the option “E-mail Notification”.
When asked about the sender, enter your own name and the following mailing address: John Adams Park 1, 2244 BZ Wassenaar. Use your own e-mail address as sender and receiver so you receive all correspondence regarding your shipment.  Print your DHL label and glue or tape it on your return envelope.  No barcode only labels as they do NOT work.

When using regular stamps note this way the shipment is not trackable. Mailing is at your own risk.