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f'or fsm passport - Micronesia Embassy

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t.<br />

2.<br />

INSTRUCTIONS F'OR FSM PASSPORT APPLICATION<br />

Revised January 2006<br />

Only FSM citizens may apply for an FSM <strong>passport</strong>. FSM <strong>passport</strong>s are issued ONLY by<br />

the FSM Department of Justice; Division of Immigration & Labor as listed below:<br />

Chiel Division of Immigration<br />

FSM Department of Justice<br />

P.O. Box PS 105<br />

Palikir, Pohnpei FM 96941<br />

Please submit only one (l) <strong>passport</strong> application. The application must be complete,<br />

signed and notarized. The application must be accompaniedby 2 color <strong>passport</strong> photos;<br />

<strong>passport</strong> fee; birth certificate (if first time applicant), affrdavit (if <strong>passport</strong> is lost, stolen<br />

or damaged) and postage fees.<br />

PHOTOS: Submit two (2) recent identical <strong>passport</strong> photos. Photos should be color. Do<br />

not sign the front of the photographs. When having picture taken: do not use sunglasses,<br />

sleeveless shirts, large combs or other articles that stick out from head. Do not use leis,<br />

hats, earrings, or other items distracting to the photograph. Official and Diplomatic<br />

<strong>passport</strong> applicants must wear appropriate attire.<br />

3. BIRTH CERTIFICATE: Only required if you are a first time applicant.<br />

4. FEES: Passport fees are $50. Please send money order or cashier's check payable to<br />

FSM Treasury. Do not send cash or personal checks. The <strong>passport</strong> fee to replace a<br />

<strong>passport</strong> that is not expired but that has been lost, damaged or stolen is $75.<br />

5.<br />

6.<br />

-<br />

AFFIDAVIT: If your <strong>passport</strong> has been lost, stolen or damaged, you MUST submit a<br />

notarized affidavit with your application. You must submit one of the following:<br />

Affidavit for Lost Passport, Affidavit for Damaged Passport, or Affidavit for Stolen<br />

Passport.<br />

POSTAGE FEES: FSM Citizens who apply for a <strong>passport</strong> from the USA must also<br />

include a money order (no cash or personal checks), payable to FSM Postmaster General,<br />

to cover cost of postage from FSM to US for completed <strong>passport</strong>. The FSM Government<br />

is no longer able to cover this expense. Please include a total of $ 1 3 .00 to cover cost of<br />

postage. The $13.00 will cover $4.05 for priority mailing (up to 1 lb.) and registered mail<br />

services (1 booklet $8.50 or 2 booklets $8.77). You must be sure that your correct<br />

mailing address is on your application.<br />

Recommendations: The FSM <strong>Embassy</strong> in Washington recommends that you keep your<br />

<strong>passport</strong> current at all times. In the case that you are renewing your <strong>passport</strong>, please<br />

remove your I-94 from your expired <strong>passport</strong> and keep it in a safe place. You may attach<br />

your I-94 in your new <strong>passport</strong> when you receive it.<br />

8.<br />

For more information, please contact the following offices:<br />

FSM Immigration Headquarters 011 (691) 320-5844<br />

Email: imhq@mail.fm<br />

FSM <strong>Embassy</strong>, Washington, DC (202) 223-4383 or the website at<br />

http://w*'w. <strong>fsm</strong>embassydc. or g


I intend to travel to ttrc following countries for tre following periods and purposes.<br />

(courvrR9 (Co{JNIRY) (coUr{rRY)<br />

(couNrRY)<br />

My last Travel Docunent was obtaind from<br />

ard is submited herewith for cancellation<br />

My photograph likeness and penonal description are giran belovr<br />

I I<br />

'READ CAREFLITLY' Apflicant is<br />

to $bmit 3 rw€nt id€ntical I 3/16<br />

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p Ecrt style phoograpbs<br />

Photogr4hsmybeincolccrblack<br />

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frmtviwvofpufrce.<br />

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l l t l<br />

(sou,ce of docr.ment)<br />

(OOUI\[RY) (COLJI.ITRB<br />

(Give Deposition ofdooment ifnct srbuitted)<br />

Itreiglre _Fet:<br />

l l SIGNATURE<br />

Subaaibed ard surom o before rB this: Dayof<br />

NOTARY<br />

PERSONALDESCRIPTION<br />

n mr" I n*"t<br />

Oolcof llair: Eym:<br />

Distinguiching noad$ q features:<br />

Evidence rnry be addrced as follows ttut tre applicarf is a citizen of tre Federated States of Microrpsi4 that he is not a rntional of any<br />

foreign courfry, and fiat he does not bear allegiance to any foreign country. (A corrylete staternent stpuld be furnisbed urder this zubdivision<br />

indicating tre natue of the widence wtrich was obtaine4 such as (l) records as to birth, nrarriage, etc. (2)Penqnl interrogation of trc<br />

applicaff, (3Interrogation of rnembers of tbe claq tribe, or comrnrnity, or (4) Whateraer other investigation is neessary in order to esablish<br />

ttr,at the applicant is a citizen ofthe Federated States of <strong>Micronesia</strong>)<br />

I tueby cenify that I am s*isfied tlat ttre applcant is a citizen of tbe Federated Sttes of Micruresi4 and tbat he./she does not owe<br />

allegiarrce o any foreigrrcoury.<br />

Age:<br />

IMMIGRATION AND LABOR OFFICER<br />

Date<br />

20


AFFIDAVIT<br />

FOR LOST/DAMAGED OR STOLEN FSM PASSPORT<br />

Application for Renewal or Replacment of FSM Passport<br />

I, _____________________________, citizen of the Federated States of <strong>Micronesia</strong><br />

(Full legal name as shown on <strong>passport</strong>)<br />

(FSM), born in __________________ State in the FSM on ____________________,<br />

(Place of Birth) (Date of Birth)<br />

hereby verify and confirm that I am applying for a renewal or replacement FSM <strong>passport</strong><br />

because my previous FSM <strong>passport</strong> was:<br />

( ) damaged and hereby attached to this application<br />

( ) stolen<br />

( ) lost<br />

I swear that this statement is true and hereby submit my application for a new FSM<br />

<strong>passport</strong>.<br />

* This affidavit must be notarized.<br />

Signature________________________________<br />

Date ________________________________

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