*72G*72G

Australian Passport Renewal Application

BEFORE YOU TRAVEL Only use this form if:
Visit the Department’s website ■ you are lodging this form before the date printed at the top of page 2 next to the arrow
www.smartraveller.gov.au ■ you are able to present the passport with the number printed at the top of page 2
to view the latest travel advice
■ your current personal details are the same as those printed in section 2.
If you cannot use this form:
PASSPORTS WEBSITE
■ apply for a passport online at www.passports.gov.au, or
www.passports.gov.au
■ call the Australian Passport Information Service (APIS) on 131 232, or
■ collect an Application for Australian Passport: Adult form from a participating Australia Post retail outlet.
FIND A PARTICIPATING
Fees: The current fee schedule is available on our website, through APIS or if you are lodging your application
AUSTRALIA POST overseas, contact an Australian diplomatic mission or consulate for advice.
RETAIL OUTLET Processing times: Please visit passports.gov.au for the latest advice on passport processing times, including
www.auspost.com.au information about how you may be able to access our Priority Processing Service for urgent travel.

137 678
Lodgement: Lodge this form in person at a participating Australia Post retail outlet if you are in
Australia. An appointment may be required. If renewing overseas contact your nearest Australian
diplomatic mission or consulate for advice.

Protect your identity Providing two identical photos of yourself

Keep your passport Width: 35mm–40mm Your photos: You must provide
safe at all times. two identical colour photos that are
Lost or stolen passports The chin to crown measurement less than six months old and meet
must be between 32mm and 36mm Australian Passport Office standards.
cause inconvenience and
(the crown is where the top of the
Height: 45mm–50mm

may be used by others

For full details of our standards visit
head/skull would be if it was visible). our website, or refer to our ‘General
to assume your identity
photo guidelines’ brochure, available
for illegal activities. NOTE: online or through APIS.
Due to security printing requirements,
Report any loss or images reproduced in passports Photos that do not meet our
theft immediately. will not be of photographic quality requirements will be rejected
and will appear different from the and this will delay the issue of
photos supplied. your passport.

Australian Passport Notice about the collection, use and disclosure of personal information
Information Service The Australian Passports Act 2005 authorises the Australian Passport Office of the Department of Foreign Affairs
(APIS) and Trade to collect the personal information provided with this application for an Australian passport, including

131 232
supporting documents and photos, to determine the applicant’s eligibility. Without this information we are unable
to process your application.

passports.australia We may also collect personal information from third parties such as law enforcement or security agencies,
@dfat.gov.au where those third parties provide us with information which is relevant to this application for a passport.
We may disclose your personal information for the provision of consular services; and to other entities or
If you have any questions
about this form or about individuals who are specified in the Australian Passports Act 2005, such as:
how to get an Australian ■ the immigration department, civil registries and licencing authorities that can verify information and assist
passport, or if you wish to establish your identity and eligibility
to comment about our
service, offer suggestions ■ Interpol and its member countries; other countries with which we have an agreement for purposes such as advising
for improvement, or register about the status of a passport; law enforcement authorities; Australian border authorities to facilitate international
a complaint, please visit travel; and law courts for the operation of family law and related matters.
our website, contact APIS
or write to the following
We are authorised by law to disclose your personal information to foreign border authorities:
address: ■ if we suspect there is unlawful activity relating to the passport
Executive Director ■ for law enforcement purposes
Australian Passport Office ■ in countries with which Australia participates in the Regional Movement Alert system.
Department of Foreign
  Affairs and Trade
We may also use your current and past information for testing, training and research purposes (phone APIS if you object).
R.G. Casey Building For information on how to access or correct personal information and how to complain about a breach of privacy,
John McEwen Crescent refer to the ‘Protecting your privacy’ brochure, available on our website, through APIS or an Australian diplomatic
Barton ACT 2600
mission or consulate.
Online form PC7_0717
Department of Foreign Affairs and Trade
Australian Passport Renewal Application *71G* 71G
*778 70806721 P* *778 70806721 P*
Your Australian
passport number: N6563322 1 Use BLACK INK and print within
Lodge
Passport expiry date: this form the boxes in B LOC K L ETTE RS
31 AUG 2022 before
31 DEC 2099

Please bring the passport with the number printed above when lodging this form. Use CROSSES in boxes ✗
Please complete sections 1,3,4, and 5.
NOTE: Your passport will be sent to the address shown below. If the address shown below is not 1 Contact details and date of travel
current, write the address beside the old one. This address must be a residential address, not a
business address or a PO Box. Preferred contact number
KEITH THOMAS ALCOCK 0 1 1 8 9 0 2 0 7 7 0
15 WEALD RISE Email address (must be written clearly in BLOCK LETTERS)
TILEHURST K T A L C O C K@O U T L OO
READING RG30 6XB K . COM
UNITED KINGDOM
Date of travel
(DD/MM/YYYY)

2 Please check your personal details— If your current details differ from those printed below DO NOT use this form. Fields marked * will appear on your passport
Family name* Given names*
ALCOCK KEITH THOMAS
Town or city of birth* Country of birth Date of birth* (DD/MM/YYYY) Sex*

Online form PC7_0717

HABERFIELD AUSTRALIA 20 JAN 1945 M
Family name on birth certificate Given names on birth certificate

Family name on Australian citizenship certificate Given names on Australian citizenship certificate

3 Type of passport required

X Ordinary passport 75+ passport

(a lower fee applies)
Note: A 75+ passport (five years validity) is available to persons aged 75 or over.
4 Emergency contact details—if there is someone we can contact in the event of an emergency, please give their details
Name of contact Relationship to you Address of contact
PETER WHITEHOUSE FRIEND 11 BRAEMAR STREET CROYDON
VICTORIA
Daytime phone number Evening phone number
( 04 ) 18555293 ( 97 ) 258734
5 Applicant’s declaration—cannot be more than six months old OFFICE USE ONLY

I understand that: It is a criminal offence under the Australian

WARNING

Passports Act 2005 to make false or

■ my photo and personal information will be used
misleading statements (there are penalties
for data and biometric matching purposes, even of up to 10 years imprisonment or a fine of
in the event that the application is withdrawn 1000 penalty units or both). Under section 19A
(biometric matching allows the passport photo of the Act, we can also refuse to process an
to be electronically compared with other facial application for an Australian travel document
images to confirm identity). if we have reasonable grounds to suspect
fraud or dishonesty in the application. This
Act applies outside Australia to all persons,
I declare that: irrespective of their nationality or citizenship.
■ I am an Australian citizen
Applicant’s signature—must be inside the white box
■ the statements that I have made and the
information that I have given in, or in
connection with, this application are true Applicant must write full name on back of one photo.
and correct
■ I have read and understood the ‘Notice about
the collection, use and disclosure of personal Date signed (DD/MM/YYYY)
information’ on page 1.

OFFICE USE ONLY — Use CROSSES in circles ✗

Method of delivery Typed details Emergency passport OAO Interviewer’s signature Work Centre Code
altered
Registered Post Interviewers declaration
Priority fee paid
I declare that: I have checked the passport number of the applicant’s PICS
Passport Office previous passport; the photo appearing therein and the attached User ID
Prev. PPT photo are of the applicant; I have/have not conducted an applicant
Date signed (DD/MM/YYYY)
cancelled interview; I have/have not cancelled the applicant’s passport;
I understand it is an offence under the Australian Passports Act
Interviewed 2005 to make a false or misleading statement.