Fillable Printable LS01 Lost or stolen passport notification

LS01 Lost or stolen passport notification

Lost or Stolen

Passport Notification

Official passport office use only

Lost or Stolen Reference

Application number

Use this form to report the loss or theft of a passport. Please write only within the white boxes.

IMPORTANT: Completing this form will not provide you with a replacement passport. To

replace your passport you will need to submit this form, a passport application form, supporting

documents and fee.

A replacement passport will not be issued if this form has not been completed correctly. As

applications to replace lost or stolen passports require additional checks please note you cannot

replace a lost or stolen passport using the Premium service. Please call our Passport

Adviceline on 0300 222 0000 or visit www.direct.gov.uk/passports for further information.

Help safeguard your identity by returning this form without delay.

Please fill in all sections that apply to you

Please complete in CAPITAL LETTERS and BLACK INK only.

Details of the

lost/stolen

passport

Title

Surname on passport

Forename(s) on passport

D D M M Y Y Y Y

Date of birth

Town of birth

Country of birth

Passport number Was the passport issued in the UK?

Yes

D D M M Y Y Y Y

Date of issue

Indicate by crossing

either the Lost,

Stolen or Other box.

Lost

Stolen Other

If Other please supply details

Current details -

only fill in if different

to Section 01

Current title

Current surname

D D M M Y Y Y Y

Current forename(s)

Details of

where and when

lost/stolen

passport last seen

Date of loss/theft

Place of loss/theft (e.g. name of airport or name and town of hotel)

Country of loss/theft

Postcode of loss/theft

Circumstances of loss/theft

LS01 10.08

Please turn over

Y Y Y Y

Police Report

The police must be notified

of passport theft in the UK.

Passports stolen abroad

must be reported to local

police of that country.

Has the theft been reported to the police? Yes No

D D M M Y Y Y Y

Date reported to police

If it has been reported to the police

then fill in the details below

Police station

Police report number

Name of person

reporting the

loss/theft.

Complete this section

only if you are not the

passport holder.

A person with parental responsibility must complete Section 05 if the passport holder is aged under 16 (this

form should not be used where there is a parental dispute over the possession of a child's passport). If you are

completing this form on behalf of an adult passport holder please enclose a covering letter explaining clearly

why the passport holder cannot complete this form him/herself.

Title

Surname

Forename(s)

Relationship to passport holder

Contact details of

person reporting

the loss/theft.

Complete this section

only if this form is not

accompanying an

application for a

replacement passport.

Present address (house number, street name, town)

Country

Postcode Daytime telephone number

Evening telephone number

Mobile telephone number

E-mail address

Declaration

Note all unsigned

forms will be

returned

I understand that completing and returning this form will result in the related passport being cancelled, that it may

never be used again and, if subsequently found, it should be returned to the Identity and Passport Service (IPS)

immediately. I also understand that I will need to make a separate application on a passport application form if I wish

to replace the passport declared lost or stolen.

The information on this form is true to the best of my knowledge and belief and I understand that I shall be liable to

prosecution and could face a prison sentence if I include anything that I know to be false or do not believe to be true.

I also understand that the IPS holds and uses data for purposes notified to the Information Commissioner under the

Data Protection Act 1998 (which may be consulted at www.informationcommissioner.gov.uk). Information about the

lost or stolen passport may be shared with appropriate public and private sector authorities who can assist in

locating and recovering the missing passport.

Print name here

Failure to keep your

signature within

the border will

invalidate the form.

Remember to enter

the date of signing in

the box provided.

Signature (sign within box) Date

D D M M

Enclose this form with your passport application form. If this form

is not accompanying an application form for a replacement

passport please send to: PO Box 654, Peterborough PE1 1WP.

If outside the mainland UK this form should be sent to the nearest

British Embassy or High Commission Consular Section, British

Consulate or Passport Issuing Office.

Office Use Only

This section should be

completed by the

submitting authority.

DATE STAMP

Source Authority (This is the unique code that represents the authority and how they report, e.g. 'FCOC' for FCO Compass).

LSR Submission Post (The specific post or office within the submitting organisation making the report).

Source Authority Source System Reference (The unique system reference ID for the LS report).

Source Contact Details (The Contact name or telephone number where report is made).