FSM Form 5001B at a glance
What it is: FSM Form 5001B is the FSM Passport Application Form, which the applicant completes and forwards to the Division of Immigration & Labor, Department of Justice, FSM National Government, Palikir, Pohnpei FM 96941.
Where and when to file: For Regular, Certified, Registered and Express Postal Office Mail, use FSM National Government Department of Justice Division of Immigration & Labor P.O. Box PS-157 Palikir, Pohnpei FSM 96941.
What to bring and attach to FSM Form 5001B
For new applicant or renewal of expired passport the following documents are required.
New Passport (New Applicant): the Passport Application Form must be Notarized; Court Registered Birth Certificate; Two Identical Passport Photos of the applicant (size: 1 3/16 x 1 ¾ passport photo); Court Registered Marriage Certificate for maiden name change.
In cases of unavailability of records of Birth Certificate, a court registered Baptismal Certificate can be submitted with your application form.
Passport Renewal: the Passport Application Form must be Notarized; the expired passport must be submitted with your Application Form; Two Identical passport photos of the applicant (size: 1 3/16 x 1 ¾ passport photo); payment of passport renewal fee payable to the FSM National Treasury in the amount indicated.
A filled-in FSM Form 5001B example: an adult applies for an Ordinary FSM passport
How to fill out FSM Form 5001B, box by box
Type of Passport
Mark the Type of Passport: Ordinary, Official or Diplomatic.
Applicant Information
Enter Name as Last Name, Middle Initial and First Name, then Other Names You Have Used.
Enter Date of Birth, mark Gender (Miss, Mrs., Ms. or Mr.), then enter Height in Feet and Inches, Hair Color, Eye Color and Birth Place.
Enter Home Address, Current Postal Address, Email Address and Phone Number.
Print all information in Block Letters.
Complete the application form with your Email Address (if applicable) or Phone Number so you can be contacted as soon as possible if your application is found to be incomplete.
Have you ever been issued a foreign passport or FSM passport?
Mark Yes or No to Have you ever been issued a foreign passport or FSM passport? If yes, enter the country of issuance, date issued and passport number.
Basis of FSM citizen
Mark the Basis of FSM citizen: Birth, Naturalization or Other means (Provide prove).
If basis of FSM Citizen is Naturalization provide copy of Naturalization Certificate.
Father Information
Under Father Information, enter Last Name, First Name, Middle Name, Birthdate and Birthplace, and mark Yes or No to Is your father FSM citizen? If no, enter what nationality.
Mother Information
Under Mother Information, enter Last Name, First Name, Middle Name, Birthdate and Birthplace, and mark Yes or No to Is your mother FSM citizen? If no, enter what nationality.
Signature of Applicant Required
Signature of Applicant Required: please sign within the box. Signature must not touch box border lines.
Do not sign in the box for infant and adult who cannot sign.
Signature of parent or guardian
Signature of parent or guardian if applicant under age 14 or unable to sign application.
Applicants who are under the age of 14 but are capable of signing the application should sign the application. However, a signature of a parent or guardian shall also be required for applicants under the age of 14.
Subscribed and sworn to before me this
Subscribed and sworn to before me this, day of and 20, with the NOTARY PUBLIC SEAL.
Fill out the Passport Application Form completely, sign it and have it notarized prior to submission to the FSM Passport Office.
More rules for FSM Form 5001B
All completed passport applications and supporting documents should be addressed and forwarded to the FSM Passport Office as required by each Courier.
If your situation is different
The applicant is unable to sign
Applicants who are 14 or older but are unable to sign the application due to incapacity or disability shall, in their own handwriting, place an “X” in the signature box.
In the event an applicant's incapacity or disability prevents the applicant from placing an “X” in the signature box, the signature box shall remain vacant and the application shall be accompanied by a written statement of a close relative, legal guardian, or medical doctor attesting to the applicant's inability to sign the application.
In such circumstances, a parent, legal guardian, or other close relative shall sign the application in the space provided for parents and guardians signature on the application form.
A passport is lost, stolen, damaged or mutilated
Passport Replacement: the Passport Application Form must be Notarized. A passport that is lost, stolen, damaged or mutilated may be replaced.
Application for a replacement shall be made by submitting an Application Form, the passport itself if available, a sworn affidavit detailing the circumstances surrounding the loss, theft, damage or mutilation of the passport; replacement fee in money order or cashiers check payable to the FSM National Treasury, and two identical passport photos of the applicant.
The Replacement fee for lost, stolen, damage and mutilated shall be $75.00 (checked October 29, 2026).
A passport has no remaining blank visa pages before the date of expiration
A passport that has no remaining blank visa pages before the date of expiration may be replaced.
Application for a replacement shall be made by submitting an Application Form, the passport, a fee of $25.00 in money order or cashiers check payable to FSM National Treasury and two identical passport photos (checked October 29, 2026).
A passport was issued to an infant under 12 months
A passport issued to an infant under 12 months may be replaced.
Application for a replacement shall be made by submitting an Application Form, the passport itself, two identical passport photos and a passport fee of $50.00 (checked October 29, 2026).
Common questions about FSM Form 5001B
Where do I file it?
For Federal Express Mail and DHL Mail Courier, use FSM National Government Department of Justice Division of Immigration & Labor Palikir, Pohnpei FSM 96941 Phone: (691) 320-5844.
What am I certifying when I sign?
You sign the application within the box, and it is Subscribed and sworn to before a NOTARY PUBLIC. “I hereby certify that I have reviewed the application and found to be complete and I am satisfied that the applicant is a citizen of the Federated States of Micronesia, and that he/she does not owe allegiance to any foreign country.” is followed by the FSM Immigration Reviewing Officer line and Date: the officer signs and dates it, not you.
Sources
[1] FSM Form 5001B, FSM Passport Application Form, FSM Department of Justice (the Official source link on this page).
