ÉirePassports Application Form

What type of application are you making?*

RenewalFirst TimeLost/StolenDamaged
What country are you applying from?*
Applicant's details*

TitleApplicant's Forename(s)Applicant's Current Surname
Maiden name or any previous name(s)*
Has your name changed since your previous passport?*

YesNo
Has your name changed since your birth certificate was issued?*

YesNo
Gender*
Place of birth*
County of birth*
Date of birth*

DayMonthYear
Is age over 18?

YesNo
Current

MonthDayYear
Date
Age
Mobile number*
Alternative phone number
Email address*
Alternative email address
Postal address (PO Box cannot be accepted)*
Is your home address the same as your postal address?*

My home address is the sameMy home address is different
Home address*
Passport number:*
Issuing date*

DayMonthYear
Date
Expiry date*

DayMonthYear
Date
Current Date

DayMonthYear
Date
Months Until expiry
Months until expiry, over 12

YesNo
What is your mother's maiden name?*
Do you have a PPSN (Personal Public Service Number)?*

YesNo
How are you eligible for an Irish passport?*

One of my parents was born on the island of IrelandI was naturalisedI have a Foreign Births Registration certificateI was adopted in compliance with Irish law
Irish-born parent's details*

Irish-born parent's forename(s)Irish-born parent's surname
Does the applicant have one or two guardians?*

One guardianTwo guardians

Guardian one
Guardian one name*

TitleForname(s)Surname
DOB*

DayMonthYear
Date
Place of birth*
County of birth*
Passport number*
Country origin of passport*
Do you live at the same address as the applicant?*

YesNo
Home address*

Guardian two
Name*

TitleForename(s)Surname
DOB*

DayMonthYear
Date
Place of birth*
County of birth*
Passport number*
Country origin of passport*
Mobile number*
Email address*
Do you live at the same address as the guardian one?*

YesNo
Home address*
Please provide the details for the parent who was born, natrulised or had residency in Ireland.
Parent's place of birth*
Parent's county of birth

Declaration and Authorisation
- I, {applicantsDetails}, declare that the information provided in this form is true and correct to the best of my knowledge and belief.
- I confirm that I have read and agree to the ÉirePassports Terms & Conditions and Privacy Policy.
- I consent to ÉirePassports processing and securely handling my personal information for the purposes of providing passport support services in accordance with applicable privacy laws.
Markerting

I agree to receiving occasional marketing emails, newsletters, and promotional updates from ÉirePassports related to passport services and relevant offers. I understand I can unsubscribe at any time.
- I, {name}, declare that the information I have provided on behalf of my child, {applicantsDetails}, is true and correct to the best of my knowledge and belief.
- I confirm that I have read and agree to the ÉirePassports Terms & Conditions and Privacy Policy.
- I consent to ÉirePassports processing and securely handling my child’s personal information for the purposes of providing passport support services in accordance with applicable privacy laws.
Markerting

I agree to receiving occasional marketing emails, newsletters, and promotional updates from ÉirePassports related to passport services and relevant offers. I understand I can unsubscribe at any time.
By signing below, I confirm that I have read and agree to the declaration above, and that the information I have provided is true and correct.*

Clear
Date

DayMonthYear
Total Amount

Payment amount

EUR

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please verify that you are human*
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Declaration and Authorisation