Web Site Living-in-the-Private (LPP) Information PRIMARY DETAILS First Name * Do you have a Middle Name? * Yes No Last Name * Height (Feet' Inches) * Hair Color * Eye Color * Current Mailing Address * Unit, Apt., Box# State * Select stateAlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUnited States Minor Outlying IslandsUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming City * Postal Code * Phone Number * Email Address * PASSPORT DETAILS Have you been issued a Passport Book? * Yes No Have you been issued a Passport Card? * Yes No Born Date (mm/dd/yyyy) * What City were you Born? * What State were you born? * Naturalized (Outside the U.S.) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Idaho Hawaii Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Were you issued a Birth Certificate (BC)? * Yes No Gender * Man Woman Name as it appears on BC or Government ID (If applicable) Government ID Type * Drivers License State ID Card Passport ID Card Passport Book Other Need to get Government ID State * N/A U.S. STATE DEPARTMENT ALABAMA ALASKA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE FLORIDA GEORGIA HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA OHIO OKLAHOMA OREGON PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING List all other names you have used (Examples: Birth Name, Maiden, Previous Marriage, Legal Name Change) Were you issued a Social Security Number (SSN) or Tax Identification Number (TIN)? * SSN TIN (If Naturalized) No Add Father Details? * Yes No FATHER DETAILS Father's Given Name * Father Last Name * DOB - MM * DD * Year * Father's Born State? * Naturalized (Outside the U.S.) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Idaho Hawaii Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Add Mother Details? * Yes No MOTHER DETAILS Mother's Maiden Name * Mother Last Name * DOB - MM * DD * YYYY * Mother's Born State? * Naturalized (Outside the U.S.) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Idaho Hawaii Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Have you ever been married? * Yes No Have you been Divorced or Widowed? * Yes No Do you have children you want to register at this time? * -- select -- No 1 2 3 4 5 LPP Adhesion Data PRIVATE FOUNDATION / CHURCH Did you purchase a Private Foundation? * Yes No FOUNDATION / CHURCH / TRUST PRIVATE MAILBOX Address 1 Address 2 City State Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUnited States Minor Outlying IslandsUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip NOTICE TO USPS LOCAL/AREA POSTMASTER Postmaster Name To find your Postmaster name and address, copy and paste the link provided: https://about.usps.com/who/profile/history/postmaster-finder/ Postmaster Address Postmaster City Postmaster State Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUnited States Minor Outlying IslandsUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Postmaster Zip Is your current mailing address the same as above (Personal Information)? Yes No NOTICE TO DEPARTMENT OF MOTOR VEHICLES OR VEHICLE ADMINISTRATION (DRIVER’S LICENSE) Do You Have a Driver's License * Yes No NOTICE TO COUNTY CLERK OR REGISTRAR OF MARRIAGES (MARRIAGE LICENSE) Do You Have a Marriage License * Yes No NOTICE TO COUNTY BOARD OF ELECTIONS (VOTER’S REGISTRATION) Do You Have a Voter's Registration * Yes No NOTICE TO COUNTY SHERIFF Sheriff Name-Current County Live * Address City * State * Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUnited States Minor Outlying IslandsUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip * NOTICE TO STATE GOVERNOR Governor Name - Current State Live * Address * City * State * Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUnited States Minor Outlying IslandsUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip *
