Passport Information for Medina County Residents

Our web site provides basic forms for obtaining passports.  If you need assistance in completing the forms or have questions regarding the documents you need to bring,  please visit the U.S. Department of State web site or call one of our Offices for more information before stopping in.  We will be happy to assist you!

 

Passport Office Fee (Effective 7/13/2010) -
  • $110 Passport Fee - Age 16 and over (passport valid for 10 years from date of issue)   OR
  • $80 Passport Fee - Age 15 and under (passport valid for 5 years from date of issue) 

Check or Money Order ONLY!  Cannot be paid in cash.  Make checks payable to the "U.S. Department of State".  

AND

Clerk of Courts Fee - 

  • $25 - Each applicant, regardless of age.  Cash, check, money order, VISA, Mastercard.  Make checks payable to David B. Wadsworth, Clerk of Courts.

Credit cards are accepted at ALL branch locations.

You may print the passport forms from this site, or obtain them from any of our offices. 

These forms are provided in Adobe Acrobat PDF format.   If you do not already have Adobe Acrobat Reader software, Click Here.    getacro.gif (712 bytes)

All passport applicants must appear in person, including minors under age 16.
Information regarding passports for children under age 16

FORM DESCRIPTION

Use this form IF:

FORM DS-11  APPLICATION FOR PASSPORT

  • You have never had a US passport, OR
  • You are under age 16, OR
  • Your most recent passport was issued more than 15 years ago.

FORM DS-82  APPLICATION FOR PASSPORT BY MAIL

 For Renewals ONLY.  Used for renewing a previously issued U.S. passport by mail at anytime OR in person at our offices.
  1. I can submit my most recent passport, AND
  2. I was at least 16 years old when my most recent passport was issued, AND
  3. I was issued my most recent passport in the last 15 years, AND
  4. I use the same name as on my most recent passport or since my passport was issued, I have had my name changed by marriage or court order and can submit proper documentation to reflect my name change.

If you answered NO to any of the 4 statements above, STOP. 
You cannot use Form DS-82, you must apply on a DS-11.

FORM DS-3053  STATEMENT OF CONSENT - ISSUANCE OF A PASSPORT TO A MINOR UNDER AGE 16

 To be submitted along with the DS-11 Application for Passport, for minors under age 16 as evidence of parental permission IF:
  • You are a non-applying parent or guardian consenting to passport issuance for your child, OR
  • You are an applying parent or guardian, and written consent of the non-applying parent or guardian cannot be obtained.

FORM DS-5504  NAME CHANGE, DATA CORRECTION AND LIMITED PASSPORT BOOK REPLACEMENT
  1. I have had a change in my name and my most recent U.S. passport book and/or U.S. passport card was issued less than one year ago; OR
  2. My identifying information in my most recent U.S. passport book and/or U.S. passport card was printed incorrectly; OR
  3. My most recent U.S. passport book was limited in validity and was issued less then one year ago.

If you answered NO to ALL of the 3 statements above, STOP. 
You cannot use Form DS-5504, you must apply on a DS-11 or DS-82 depending on your circumstances.

FORM DS-4085  APPLICATION FOR ADDITIONAL VISA PAGES OR MISCELLANEOUS PASSPORT SERVICES

  

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