Lost or Stolen Non-U.S. Passports Containing Valid U.S. Visas

(日本語)

If your passport containing a valid U.S. visa is lost or stolen, you are required to report the loss or theft to the Embassy. Please send this form with the information below. We will enter it in our database. Please make sure that your information is correct and complete, as the incorrect information will not be reflected in our system.

Please note: Once you have reported your passport as lost or stolen, we will not be able to amend your record should you find the passport. The passport and the visa can no longer be used for travel to the United States.

Nonimmigrant Visa Holders

If your passport is ever recovered, it can no longer be used for travel to the United States, including registering under ESTA. Once you have obtained a new passport, you may apply for a new visa, if required. Via Waiver Program traveler may wish to click this link to determine their eligibility. If you are eligible to travel visa free, you will not be required to replace the visa.

Immigrant Visa Holders

If your passport is ever recovered, it can no longer be used for travel to the United States. If your passport contained an immigrant or K visa, and you have been admitted as a Conditional or Permanent Resident and have received your card, you are not required to replace the visa. If you have been admitted as a Conditional or Permanent Resident but have yet to receive your Resident Card, you will require a Boarding Foil to return to the United States. Please note that a Boarding Foil may only be issued within 30 days of your proposed date of travel.

U.S. Passport Holders

If you wish to report the loss or theft of a U.S. passport, please contact American Citizen Services.

This form is only used to inform us that you have lost/stolen your passport. This form cannot be used for general inquiries. For general inquiries, please use the Visa Information Service.


1.
Full name (as in passport):
2.
Date of birth:
3.
Place of birth:
4.
Number of the passport that was lost/stolen (not current):
5.
If there was a valid U.S. visa in the lost/stolen passport, what type of visa was it?
6.
Where was the U.S. visa issued?
7.
Telephone number:
8.
E-mail Address:
9.
Loss or theft reported to police and/or your embassy?
 Yes   No
If "Yes", please fax or mail us a copy of the report. Our fax number is 03-3224-5151. Our mailing address is 1-10-5, Akasaka, Minato-ku, Tokyo 107-8420 Attention: Visa Communication Unit.
10.
Description of loss:
11.
Are you submitting this form on behalf of someone else?
 Yes   No
12.
If "Yes", please specify your relationship to the passport holder:
 
 
  

Please note that we may contact you at the telephone number or email address you provide here.