Report of Lost Passport with Valid U.S. Visa

If you wish to replace a lost or stolen visa, you will need to return to the Consular Section for an interview. In addition to the documentation required for a visa application, you must fill out the form below.

You will also need to bring a DAS certification of your entries to and exits from Colombia since 1990 (entradas y salidas) in a sealed envelope. This may be obtained at the Bogota office of DAS, located at Calle 100 # 11B-27, Edificio Platinum.

Fill out one report per person.
Please attach a copy of your police report.

Complete name of applicant: __________________________________________

Date and place of birth: ______________________________________________

Cedula number: ____________________________________________________

Address: _________________________________________________________

City, Dept.: ________________________ Telephone number: _______________

Place and date of issuance of the lost passport: ___________________________

U.S. visa class: ____________________________________________________

Marital status: _____________________________________________________

Occupation: ______________________________________________________

Name of husband/wife: _____________________________________________

Complete name of applicant's father: _________________________________

Complete name of applicant's mother: ________________________________

Date and place where passport was lost: ______________________________

Date police report was filed (attach copy): ______________________________

Brief explanation of how passport was lost: ______________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________

Signature: ____________________________________

Name: _______________________________________   Date: _______________

This form cannot be sent via e-mail. Print it, fill it out completely and send it immediately with a copy of the police report to: Sección Consular Visas de No-inmigrante Carrera 45 # 22D-45 Bogotá, D.C. Or fax it to: (571) 315-2127