Application for Additional Pages to US Passport

• The passport must be in good condition, no damage
• The passport will not expire within 1 year

• Fill out DS-4085 form online from US State Department website. This online application has replaced "hand written" forms. Hand written form is no longer acceptable. The last page of the application is a Print summary page, please scroll to the bottom left corner of this page and click Create Form, your application form will appear on your screen. Print out the form
• Please print out and submit only one-sided pages of the application
• Please make sure signature on this application form match the signature on your passport

• This is your authorization to VisaRite to act as your agent in dealing with the US Passport Agency. Click the link for Passport Authorization Letter. The Authorization Letter must have your original signature. Faxes or photo copies are not accepted. Please make sure signature on this letter match the signature on your old passport.

• Make one check payable to "U.S. Department of State" for $142 (this is the government processing and expedite fee). Be sure to include your date of birth on the check. If you have multiple applications, please make separate check for each applicant. Do not combine them into one check. Starter check is not acceptable.

• We accept money order, cashiers check, bank check, certified check, company check or cash. Please make check or money order payable to VisaRite Service.
• You may also pay by credit card. If you select this option, please fill out and sign one credit card charge authorization form and enclose it in your application package.
• US Department must be paid separately in check.
• Return Shipping Fee listed is for return address within the continental U.S. If your return address is in Alaska, Canada, Hawaii, Puerto Rico or the US Virgin Islands, please include an additional $10.00 per order.

• This is the best way to tell us your application is coming as well as your return address and contact information so that confirmation and status updated can be sent to you via email.
• Multiple applicants can be entered using one service request form.
• Please print two copies of the confirmation page.
• Please include one copy with the documents you ship to us and keep one copy for your records.

VISARITE SERVICES, INC.
325 W 38th Street
Suite 1105
New York, NY 10018
Tel: (212) 600-8658