The form should be downloaded and printed on white letter-sized (U.S.) 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 sections 1 to 22 on the application form in block letters and black ink. This information is mandatory.
Item 5 – Social Security Number: You must complete this item (more information). If you have never had a Social Security Number (SSN), write zeros in the boxes. If you have a number, but lost it or do not remember it, contact the social security administration. If you were issued a passport previously, we may be able to assist you to find your number.
Item 13 – Mailing Address: Complete this item with a local (Dutch Caribbean) address, either your home address or the address where you are staying. Please note that you may choose to have your new passport sent to a different address when it is ready, but passports can only be delivered to our consular district.
Item 14 – Permanent Address or Residence: Complete this item with any address you consider to be your permanent address. This need not be in the Dutch Caribbean or the U.S.
Items 18 and 22 – Travel Plans and Emergency Contact: This information is not required, but may be helpful in processing your application and in assisting you in the future.
Item 23 – Oath & Signature: Do not sign this yet as you are required to sign in the presence of the consular officer. You must read the “Acts or Conditions” on page four of this form before you proceed further. 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.