Rock County, WI
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Lisa Tollefson
County Clerk
608-757-5660
Email
County Clerk
Rock County Courthouse
51 South Main Street
Janesville, WI 53545
Passports
Passport Applications
APPOINTMENTS ARE RECOMMENDED AND WILL BE GIVEN PRECEDENCE OVER WALK-INS.
SCHEDULE AN APPOINTMENT
Passports are processed 8:00 am to 4:00 pm, Monday through Friday.
Passport payments sent with applications to the U.S. Department of State are payable by check (personal, certified, cashiers, travelers) or money order only.
Passport Book
- Valid for international travel by air, land and sea.
- Applicants 16 and older, valid for 10 years.
- Applicants under age 16, valid for 5 years.
Passport Card
- Not valid for international travel by air.
- Only valid when entering the U.S. at land border crossings and sea ports-of-entry from Mexico, Canada, Bermuda and the Caribbean.
- Applicants 16 and older, valid for 10 years.
- Applicants under age 16, valid for 5 years.
When completing the Application, the applicant can choose to apply for the U.S. Passport Book, U.S. Passport Card or both.
Applicants 18 or Older and Applying for the First Time
The applicant must apply in person and have the following when applying at our office:
- Passport Application (Form DS-11). Print Application on one side only, not back-to-back.
Please note: You are required to list your Social Security Number on the Application. - Passport Photo. At least one (1) photograph that is in color, 2x2 inches and meets with passport requirements. Our office can take photos at the cost of $17.00.
- Proof of Citizenship.
- Certified birth certificate which has been registered with the state in which you were born. The certified birth certificate must contain the applicant’s parent(s) full name(s).
- Hospital ‘birth certificates’ are not acceptable.
- Birth registrations are not acceptable.
- Naturalization Certificate. Naturalized U.S. citizens must submit the original signed naturalization certificate in lieu of a birth certificate.
- Certified birth certificate which has been registered with the state in which you were born. The certified birth certificate must contain the applicant’s parent(s) full name(s).
- Proof of Identity. Documents that are accepted as proof of identity, must be valid (not expired) and contain the applicant’s signature, are:
- Driver’s License
- State issued identification card
- Government employee identification card
- Military identification
- Payment.
Applicants 18 or Older and Current U.S. Passport Is Valid but Has Been Lost, Stolen, or Damaged
The applicant must apply in person and have the following when applying at our office:
- Passport Application (Form DS-11). Print Application on one side only, not back-to-back.
Please note: You are required to list your Social Security Number on the Application. - Passport Photo. At least one (1) photograph that is in color, 2x2 inches and meets with passport requirements. Our office can take photos at the cost of $17.00.
- Proof of Citizenship.
- Certified birth certificate which has been registered with the state in which you were born. The certified birth certificate must contain the applicant’s parent(s) full name(s).
- Hospital ‘birth certificates’ are not acceptable.
- Birth registrations are not acceptable.
- Naturalization Certificate. Naturalized U.S. citizens must submit the original signed naturalization certificate in lieu of a birth certificate.
- Certified birth certificate which has been registered with the state in which you were born. The certified birth certificate must contain the applicant’s parent(s) full name(s).
- Proof of Identity. Documents that are accepted as proof of identity, must be valid (not expired) and contain the applicant’s signature, are:
- Driver’s License
- State issued identification card
- Government employee identification card
- Military identification
- Statement Regarding Lost or Stolen Passport. (Form DS-64), if not reported online at the U.S. Department of State website.
- Payment.
Applicants 18 or Older and Previous U.S. Passport Was Issued More Than 15 Years Ago
The applicant must apply in person and have the following when applying at our office:
- Passport Application (Form DS-11). Print Application on one side only, not back-to-back.
Please note: You are required to list your Social Security Number on the Application. - Passport Photo. At least one (1) photograph that is in color, 2x2 inches and meets with passport requirements. Our office can take photos at the cost of $17.00.
- Proof of Citizenship.
- Fully-valid, undamaged U.S. passport (may be expired)
or - Certified birth certificate which has been registered with the state in which you were born. The certified birth certificate must contain the applicant’s parent(s) full name(s).
- Hospital ‘birth certificates’ are not acceptable.
- Birth registrations are not acceptable.
- Naturalization Certificate. Naturalized U.S. citizens must submit the original signed naturalization certificate in lieu of a birth certificate.
- Fully-valid, undamaged U.S. passport (may be expired)
- Proof of Identity. Documents that are accepted as proof of identity, must be valid (not expired) and contain the applicant’s signature, are:
- Driver’s License
- State issued identification card
- Government employee identification card
- Military identification
- Payment.
Applicants Ages 16 or 17
The applicant and one (1) parent or legal guardian shall appear in person and have the following when applying at our office:
- Passport Application (Form DS-11). Print Application on one side only, not back-to-back.
Please note: You are required to list your Social Security Number on the Application. - Passport Photo. At least one (1) photograph that is in color, 2x2 inches and meets with passport requirements. Our office can take photos at the cost of $17.00.
- Proof of Citizenship.
- Fully-valid, undamaged U.S. passport (may be expired)
or - Certified birth certificate which has been registered with the state in which you were born. The certified birth certificate must contain the applicant’s parent(s) full name(s).
- Hospital ‘birth certificates’ are not acceptable.
- Birth registrations are not acceptable.
- Naturalization Certificate. Naturalized U.S. citizens must submit the original signed naturalization certificate in lieu of a birth certificate.
- Fully-valid, undamaged U.S. passport (may be expired)
- Proof of Identity for both* the applicant and the parent of legal guardian. Documents that are accepted as proof of identity, must be valid (not expired) and contain the applicant’s signature, are:
- Driver’s License
- State issued identification card
- Passport (parent or legal guardian only)
- Government employee identification card
- Military identification
- Consular ID Card
In certain circumstances, to show parental relationship to the minor applicant, additional documentation may be requested. Examples of such documentation are: a certified copy of a court-ordered name change, marriage certificate or divorce decree.
* If the minor applicant does not have any of the above forms of identification, the parent’s or legal guardian’s proof of identity is sufficient.
- Payment.
If the applicant acquired citizenship under the Child Citizenship Act of 2000, has one parent that is a U.S. Citizen by birth or naturalization, or was adopted by U.S. Citizen Parent(s), please contact our office for further information.
Applicants Age 15 and Under
The minor child and both parents/legal guardian(s) must appear in person.
- If only one (1) parent or legal guardian appears for a minor child under 16, one of the following must also be submitted:
- Citizenship document listing only one parent or legal guardian.
- Adoption decree listing only one parent.
- Notarized statement from non-applying parent or legal guardian consenting to passport issuance for the minor (Form DS-3053) and a copy of the front and back sides of the non-applying parent’s or legal guardian’s identification.
- Certified court order granting sole custody to the applying parent.
- Certified Letters of Guardianship where one person is named as legal guardian of the minor child.
- Certified Death Certificate of non-applying parent or legal guardian.
- Completed Statement of Exigent/Special Family Circumstances (Form DS-5525).
- Passport Application (Form DS-11). Print Application on one side only, not back-to-back.
Please note: You are required to list your Social Security Number on the Application. - Passport Photo. At least one (1) photograph that is in color, 2x2 inches and meets with passport requirements. Our office can take photos at the cost of $17.00.
- Applicant’s certified birth certificate which has been registered with the state in which the applicant was born. The certified birth certificate must contain the applicant’s parent(s) full name(s).
- Hospital ‘birth certificates’ are not acceptable.
- Birth registrations are not acceptable.
- Proof of Identity for the parents or legal guardians. Documents that are accepted as proof of identity, must be valid (not expired) and contain the applicant’s signature, are:
- Driver’s License
- State issued identification card
- Passport
- Government employee identification card
- Military identification
- Consular ID Card
In certain circumstances, to show parental relationship to the minor applicant, additional documentation may be requested. Examples of such documentation are: a certified copy of a court-ordered name change, marriage certificate or divorce decree. - Previous Passport - If the applicant's passport is unexpired, the passport must be submitted with the application. A passport cannot be submitted in place of a birth certificate for minors age 15 and under.
- Payment.
If the applicant acquired citizenship under the Child Citizenship Act of 2000, has one or both parents that are U.S. Citizens by birth or naturalization, or was adopted by U.S. Citizen Parent(s), please contact our office for further information.
Renewal Passport Application DS-82
To find out if you are eligible to use Renewal Passport Application DS-82, answer the questions below. If any of the below requirements do not apply to you, you must use Passport Application DS-11 (printed one-sided only, not back-to-back) and apply in our office.
- I can submit my most recent U. S. passport book and/or U.S. passport card with this application.
- I was at least 16 years old when my most recent U. S. passport book and/or passport card was issued.
- I was issued my most recent U.S. passport book and/or passport card less than 15 years ago.
- The U.S. passport book and/or U.S. passport card that I am renewing has not been mutilated, damaged, lost, stolen or subsequently found.
- My most recent passport was valid for 10 years.
- I use the same name as on my most recent U.S. passport book and/or U.S. passport card --OR-- I have had my name changed and can provide documentation of the name change.
If all of the above requirements apply to you, you are eligible to use the Renewal Passport Application DS-82. Please follow the instructions below.
If you are eligible to use Renewal Passport Application DS-82, the renewal process is completed on your own.
If you need the Renewal Passport Application (Form DS-82) and/or assistance with assembling the documentation to mail, we will be happy to assist you.
You will take the application, existing passport, accompanying documentation (if applicable) and payment to the post office to mail to a National Passport Processing Center.
You can obtain the application and information on how to submit any required documentation in our office, or by visiting travel.state.gov.
If you wish to complete the Renewal Application (Form DS-82) in our office, the following is required:
- Passport Application (Form DS-82). Print Application on one side only, not back-to-back.
Please note: You are required to list your Social Security Number on the Application. - Passport Photo. At least one (1) photograph that is in color, 2x2 inches and meets with passport requirements.
Our office can take photos at the cost of $17.00. We accept cash, check, money order, or debit/credit cards. (Service fees will be charged for all debit/credit card transactions.) - Applicant’s most recent, not canceled passport.
- Certified documentation of name change, if applicable.
- Payment.
When applying for a passport, there are fees payable to the U.S. Department of State and fees payable to Rock County Clerk. These fees cannot be combined on the same check or money order.
Fees
Use these tables only if you are submitting form Passport Application DS-11.
U.S. Department of State fees are payable by check (personal, certified, cashiers, travelers) or money order only.
Service | Fee (16 and Over) |
Fee (Under 16) |
---|---|---|
Passport Book Only | $130 | $100 |
Passport Card Only | $30 | $15 |
Both Passport Book and Passport Card | $160 | $115 |
Expedite Fee | $60 | $60 |
Priority Mail Express available for Passport Book only (1-2 day expedited return service) | $21.36 | $21.36 |
Age of Applicant
Please Select Book, Card or Both
Due to U.S. Department of State: $0
Rock County Clerk's Office fees are payable by debit/credit, check or cash.
Service | Fee |
---|---|
Counter Fee - Required for Each Application | $35 |
Photo | $17 |
Priority Mail Express to the State Department | $32 |
Due to Rock County Clerk's Office: $32
Please contact us at 608-757-5660 for questions.
Passport Photos can be taken at the Rock County Clerk's office for a charge of $17.
To avoid processing delays, be sure your photo meets all the following requirements:
• Taken less than six months ago
• Head must be 1-1 3/8 inches from the bottom of the chin to the top of the head
• Head must face the camera directly with full face in view
• No eyeglasses, head covering and no uniforms or camouflage attire
• Printed on matte or glossy photo quality paper
• Use a plain white or off-white background
See the full list of photo requirements on travel.state.gov/photos.
*Head coverings are not acceptable unless you submit a signed statement verifying that it is part of recognized, traditional religious attire that is customarily or required to be worn continuously in public or a signed doctor's statement verifying its daily use for medical purposes. Glasses or other eyewear are not acceptable unless you submit a signed statement from a doctor explaining why you cannot remove them (e.g., during the recovery period from eye surgery).
If you have an overseas emergency or extremely urgent travel scheduled, you may be required to apply in person for a will-call service. Customers should call the National Passport Information Center at 1-877-487-2778 to schedule an appointment with the Chicago Agency.
The Chicago Agency is one of a number of Passport Agencies that has installed an appointment system to improve customer service. The Chicago Agency is open to the public from 9 am to 4 pm, Monday through Friday, excluding Federal holidays.
Chicago Passport Agency
101 Ida B. Wells Drive, 9th Floor
Chicago, IL 60605
Passport Corrections
There is no fee when submitting Application Form DS-5504, unless expedited service is requested.
If your identifying information on your most recent U.S. Passport book or card was printed incorrectly, you can use Application Form DS-5504 to correct your U.S. Passport book or card. The following documents must be submitted with the Application Form DS-5504:
- Your most recent U.S. Passport book and/or card.
- At least one (1) photograph that is in color, 2x2 inches and meets with passport requirements.
**If your most recent passport was issued within the last 90 days, you can verify if a new photo is required with the National Passport Information Center (NPIC) by calling 877-487-2778 (TDD: 888-874-7793) or by e-mailing NPIC@state.gov.
- Evidence supporting the correct information (i.e., certified birth certificate, certified marriage certificate, etc.). If you cannot provide evidence supporting the correct information, you must apply by using Application Form DS-11 or DS-82, depending on your circumstances. Please refer to those forms, visit travel.state.gov or contact the NPIC for more information.
Name Change Within 1 Year of Passport Issuance
There is no fee when submitting Form DS-5504, unless expedited service is requested.
If your name has changed less than one year after your U.S. passport book and/or card was issued AND your U.S. passport book and/or card is less than one year old, you can use Application Form DS-5504. The following documents must be submitted with the Application Form DS-5504:
- Your most recent U.S. Passport book and/or card.
- At least one (1) photograph that is in color, 2x2 inches and meets with passport requirements.
**If your most recent passport was issued within the last 90 days, you can verify if a new photo is required with the National Passport Information Center (NPIC) by calling 877-487-2778 (TTY/TDD: 888-874-7793) or by e-mailing NPIC@state.gov.
- Evidence supporting the correct information (i.e., certified birth certificate, certified marriage certificate, etc.). If you cannot provide evidence supporting the correct information, you must apply by using Application Form DS-11 or DS-82, depending on your circumstances. Please refer to those forms, visit travel.state.gov or contact the NPIC for more information.
Limited in Validity
There is no fee when submitting Form DS-5504, unless expedited service is requested.
If you are re-applying because your U.S. passport book was limited in validity due to a lack of citizenship evidence or identity, use Application Form DS-5504. You must submit evidence of your U.S. citizenship (certified birth certificate, U.S. Certificate of Naturalization, etc.) and/or evidence of your identity (driver's license, state issued identification card, etc.). You must establish your citizenship and identity to the satisfaction of Passport Services. Additional evidence may be requested to corroborate your claim to U.S. citizenship and/or your identity.
Passports limited in validity due to serious damage or multiple losses cannot be extended. Please contact the National Passport Information Center (NPIC) by calling 877-487-2778 (TTY/TDD: 888-874-7793), or visit travel.state.gov for more information and instructions.
If your passport was limited due to gender transition, please visit travel.state.gov for information on what documentation you will need to submit with Application Form DS-5504.
If you have any questions relating to immigration matters, please refer to the INS Service Center at 1-800-375-5283. INS operators are available 8 am to 6 pm, Monday through Friday. Automated information is available 24 hours a day, 7 days a week.
Our office will only accept a certified birth certificate that is registered with the Register of Deeds/Bureau of Vital Statistics in the County/State in which you were born. You can order a certified birth certificate by phone or online with a credit card for most states.
For information, call 1-800-255-2414, or to find the Vital Records office for each state, visit the Vital Records website.
If you need to inquire about the issuance of your passport, the National Passport Information Center (NPIC) can assist you. You may speak with a Customer Service Representative by calling: 1-877-487-2778 (TTY/TDD Users: 1-888-874-7793). Customer Service Representatives are available Monday-Friday (excluding federal holidays).
You can also e-mail the NPIC at NPIC@state.gov.
All services are available in English and Spanish.
These links can be helpful when inquiring about your passport application:
Website | What you will find on the page |
Processing Times webpage | Current and previous processing times |
Application Status webpage | Learn about what each status update means, and how to upgrade service |
Forms
All passport forms must be printed full size and one-sided only. The US Department of State will not accept forms printed back-to-back or forms printed at a reduced size.
To complete a passport application online using a form filler, visit the U.S. Department of State’s Bureau of Consular Affairs website. If you make an error or miss a field, do not hand write in the information. Complete a new form.
You can also print any of the forms below and complete using black ink only.
If you make an error, do not cross out or use whiteout. Complete a new form.
- DS-11: Application for a U.S. Passport
- DS-82: U.S. Passport Renewal Application for Eligible Individuals
- DS-5504: Application for a U.S. Passport – Corrections, Name Change within 1 Year of Passport Issuance, and Limited Passport Holders
- DS-60: Affidavit Regarding a Change of Name
- DS-64: Statement Regarding Lost or Stolen Passport
- DS-3053: Statement of Consent – Issuance of a Passport to a Minor Under Age 16
- DS-5525: Statement of Exigent/Special Family Circumstances – For Issuance of a Passport to a Minor Under Age 16
- DS-86: Statement of a Non-Receipt of a U.S. Passport
Forms are also available in our office.
Links
Our office does not process U.S. Visas. To obtain information on U.S. Visas, you can visit the Department of State website.
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