Your Name
Your Address
City, State, Zip Code
DATE
Passport Office
Address
City, State, Zip Code
Re: Cancellation of passport (#123456789)
To Whom It May Concern:
I am (Your Name) and I am writing to ask that you cancel my (Name of Country) passport with the number #123456789 that was issued on (Date) as I have got a new passport on (Date).
Thank you for your assistance in revoking my passport.
Regards,
Signature
Your Name and Phone Number
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