Extended Expiration Date (EED) Application

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TWIC Replace Card
Enter Information

* Required fields

Please enter your information below to determine if you are eligible for a card replacement or EED.
Then click ‘Next’ to continue.
*First Name

Middle Name

John

Steven

*Last Name

Suffix

Smith
*Gender

*Date of Birth

Male

12/30/1972

Preferred Language

English

December 30, 1972

*Method of Contact 1
Country Code

United States (+1)

Phone

615-123-4567

*Method of Contact 2
Method

*Primary Method of Contact

Method of Contact 1

Next

PRIVACY ACT STATEMENT:
Authority: The authority for collecting this information is 49 U.S.C. 114, 40113, and 49 U.S.C. 5103a.
Purpose: This information is needed to verify your identity and to conduct a security threat assessment to evaluate your
eligibility for a Transportation Worker Identification Credential.
Routine Uses: Routine uses of this information include disclosure to the FBI to retrieve your criminal history record; to TSA
contractors or other agents who are providing services relating to the security threat assessments; to appropriate
governmental agencies for licensing, law enforcement, or security purposes, or in the interests of national security; and to
foreign and international governmental authorities in accordance with law and international agreement.
Disclosure: )XUQLVKLQJWKLVLQIRUPDWLRQLVYROXQWDU\KRZHYHUIDLOXUHWRSURYLGHLWZLOOGHOD\DQGPD\SUHYHQWFRPSOHWLRQ
of your security threat assessment.

PAPERWORK REDUCTION ACT STATEMENT:
Statement of Public Burden: TSA is collecting this information to determine your eligibility for a TWIC. This is a voluntary
collection of information but failure to provide the information may result in an inability to approve your eligibility for a TWIC.
TSA estimates that the total average burden per response associated with this collection for enrollment is approximately 
minutes. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information
unless it displays a valid OMB control number. The control number assigned to this collection is OMB 1652-0047, which
expires 09/30/2013.

If you need assistance, please call 855-DHS-UES1 (855-347-8371) between 8am – 10pm EST Mon.-Fri.

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TWIC Replace Card
Enter Information

* Required fields

Ineligible for a card replacement.
Based on the information provided, your current TWIC is expired. If the information you entered is inaccurate,
please correct and click ‘Next’ to try again. If your TWIC is not expired, please call 855-DHS-UES1 (855-347-8371).
Please enter your information below to determine if you are eligible for a card replacement or EED.
Then click ‘Next’ to continue.
*First Name

Middle Name

John

Steven

*Last Name

Suffix

Smith
*Gender

*Date of Birth

Male

12/30/1972

Preferred Language

English

December 30, 1972

*Method of Contact 1
Country Code

United States (+1)

Phone

615-123-4568

*Method of Contact 2
Method

*Primary Method of Contact

Method of Contact 1

Next
PRIVACY ACT STATEMENT:
Authority: The authority for collecting this information is 49 U.S.C. 114, 40113, and 49 U.S.C. 5103a.
Purpose: This information is needed to verify your identity and to conduct a security threat assessment to evaluate your
eligibility for a Transportation Worker Identification Credential.
Routine Uses: Routine uses of this information include disclosure to the FBI to retrieve your criminal history record; to TSA
contractors or other agents who are providing services relating to the security threat assessments; to appropriate
governmental agencies for licensing, law enforcement, or security purposes, or in the interests of national security; and to
foreign and international governmental authorities in accordance with law and international agreement.
Disclosure: Furnishing this informaWLRQ is voluntary; however, failure toSURYLGHLWZLOOGHOD\DQGPD\SUHYHQWFRPSOHWLRQ
of your security threat assessment.

PAPERWORK REDUCTION ACT STATEMENT:
Statement of Public Burden: TSA is collecting this information to determine your eligibility for a TWIC. This is a voluntary
collection of information but failure to provide the information may result in an inability to approve your eligibility for a TWIC.
TSA estimates that the total average burden per response associated with this collection for enrollment is approximately 
minutes. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information
unless it displays a valid OMB control number. The control number assigned to this collection is OMB 1652-0047, which
expires 09/30/2013.

If you need assistance, please call 855-DHS-UES1 (855-347-8371) between 8am – 10pm EST Mon.-Fri.
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TWIC Replace Card
Enter Information

* Required fields

Unable to determine eligibility.
Based on the information provided, we were unable to locate you in our system. If the information you entered
is inaccurate, please correct and click ‘Next’ to try again. If your information is correct and you feel this message
is an error, please call 855-DHS-UES1 (855-347-8371).
Please enter your information below to determine if you are eligible for a card replacement or EED.
Then click ‘Next’ to continue.
*First Name

Middle Name

John

Steven

*Last Name

Suffix

Smith
*Gender

*Date of Birth

Male

12/30/1972

Preferred Language

English

December 30, 1972

*Method of Contact 1
Country Code

United States (+1)

Phone

615-123-4568

*Method of Contact 2
Method

*Primary Method of Contact

Method of Contact 1

Next
PRIVACY ACT STATEMENT:
Authority: The authority for collecting this information is 49 U.S.C. 114, 40113, and 49 U.S.C. 5103a.
Purpose: This information is needed to verify your identity and to conduct a security threat assessment to evaluate your
eligibility for a Transportation Worker Identification Credential.
Routine Uses: Routine uses of this information include disclosure to the FBI to retrieve your criminal history record; to TSA
contractors or other agents who are providing services relating to the security threat assessments; to appropriate
governmental agencies for licensing, law enforcement, or security purposes, or in the interests of national security; and to
foreign and international governmental authorities in accordance with law and international agreement.
Disclosure: Furnishing this informationis voluntary; however, failure to SURYLGHLWZLOOGHOD\DQGPD\SUHYHQWFRPSOHWLRQ
of your security threat assessment.

PAPERWORK REDUCTION ACT STATEMENT:
Statement of Public Burden: TSA is collecting this information to determine your eligibility for a TWIC. This is a voluntary
collection of information but failure to provide the information may result in an inability to approve your eligibility for a TWIC.
TSA estimates that the total average burden per response associated with this collection for enrollment is approximately 
minutes. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information
unless it displays a valid OMB control number. The control number assigned to this collection is OMB 1652-0047, which
expires 09/30/2013.

If you need assistance, please call 855-DHS-UES1 (855-347-8371) between 8am – 10pm EST Mon.-Fri.
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TWIC Replace Card
Enter Information

* Required fields

Unable to determine eligibility.
If the information you entered is inaccurate, please correct and click ‘Next’ to try again. If your information is
correct, please call 855-DHS-UES1 (855-347-8371) for more information.
Please enter your information below to determine if you are eligible for a card replacement or EED.
Then click ‘Next’ to continue.
*First Name

Middle Name

John

Steven

*Last Name

Suffix

Smith
*Gender

*Date of Birth

Male

12/30/1972

Preferred Language

English

December 30, 1972

*Method of Contact 1
Country Code

United States (+1)

Phone

615-123-4568

*Method of Contact 2
Method

*Primary Method of Contact

Method of Contact 1

Next
PRIVACY ACT STATEMENT:
Authority: The authority for collecting this information is 49 U.S.C. 114, 40113, and 49 U.S.C. 5103a.
Purpose: This information is needed to verify your identity and to conduct a security threat assessment to evaluate your
eligibility for a Transportation Worker Identification Credential.
Routine Uses: Routine uses of this information include disclosure to the FBI to retrieve your criminal history record; to TSA
contractors or other agents who are providing services relating to the security threat assessments; to appropriate
governmental agencies for licensing, law enforcement, or security purposes, or in the interests of national security; and to
foreign and international governmental authorities in accordance with law and international agreement.
Disclosure: Furnishing this information is voluntary; however, failure to SURYLGHLWZLOOGHOD\DQGPD\SUHYHQWFRPSOHWLRQ
of your security threat assessment.

PAPERWORK REDUCTION ACT STATEMENT:
Statement of Public Burden: TSA is collecting this information to determine your eligibility for a TWIC. This is a voluntary
collection of information but failure to provide the information may result in an inability to approve your eligibility for a TWIC.
TSA estimates that the total average burden per response associated with this collection for enrollment is approximately 
minutes. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information
unless it displays a valid OMB control number. The control number assigned to this collection is OMB 1652-0047, which
expires 09/30/2013.

If you need assistance, please call 855-DHS-UES1 (855-347-8371) between 8am – 10pm EST Mon.-Fri.
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TWIC Replace Card
Enter Information

* Required fields

Server error.
We are currently experiencing technical difficulties and are unable to process your request. Please try again
later or call 855-DHS-UES1 (855-347-8371).
Please enter your information below to determine if you are eligible for a card replacement or EED.
Then click ‘Next’ to continue.
*First Name

Middle Name

John

Steven

*Last Name

Suffix

Smith
*Gender

*Date of Birth

Male

12/30/1972

Preferred Language

English

December 30, 1972

*Method of Contact 1
Country Code

United States (+1)

Phone

615-123-4568

*Method of Contact 2
Method

*Primary Method of Contact

Method of Contact 1

Next
PRIVACY ACT STATEMENT:
Authority: The authority for collecting this information is 49 U.S.C. 114, 40113, and 49 U.S.C. 5103a.
Purpose: This information is needed to verify your identity and to conduct a security threat assessment to evaluate your
eligibility for a Transportation Worker Identification Credential.
Routine Uses: Routine uses of this information include disclosure to the FBI to retrieve your criminal history record; to TSA
contractors or other agents who are providing services relating to the security threat assessments; to appropriate
governmental agencies for licensing, law enforcement, or security purposes, or in the interests of national security; and to
foreign and international governmental authorities in accordance with law and international agreement.
Disclosure: Furnishing this information is voluntary; however, failure toSURYLGHLWZLOOGHOD\DQGPD\SUHYHQWFRPSOHWLRQ
of your security threat assessment.

PAPERWORK REDUCTION ACT STATEMENT:
Statement of Public Burden: TSA is collecting this information to determine your eligibility for a TWIC. This is a voluntary
collection of information but failure to provide the information may result in an inability to approve your eligibility for a TWIC.
TSA estimates that the total average burden per response associated with this collection for enrollment is approximately 
minutes. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information
unless it displays a valid OMB control number. The control number assigned to this collection is OMB 1652-0047, which
expires 09/30/2013.

If you need assistance, please call 855-DHS-UES1 (855-347-8371) between 8am – 10pm EST Mon.-Fri.
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TWIC Replace Card
Enter Information

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Service unavailable.
We are currently experiencing a high volume of requests. Please try again or call 855-DHS-UES1 (855-347-8371).
Please enter your information below to determine if you are eligible for a card replacement or EED.
Then click ‘Next’ to continue.
*First Name

Middle Name

John

Steven

*Last Name

Suffix

Smith
*Gender

*Date of Birth

Male

12/30/1972

Preferred Language

English

December 30, 1972

*Method of Contact 1
Country Code

United States (+1)

Phone

615-123-4568

*Method of Contact 2
Method

*Primary Method of Contact

Method of Contact 1

Next
PRIVACY ACT STATEMENT:
Authority: The authority for collecting this information is 49 U.S.C. 114, 40113, and 49 U.S.C. 5103a.
Purpose: This information is needed to verify your identity and to conduct a security threat assessment to evaluate your
eligibility for a Transportation Worker Identification Credential.
Routine Uses: Routine uses of this information include disclosure to the FBI to retrieve your criminal history record; to TSA
contractors or other agents who are providing services relating to the security threat assessments; to appropriate
governmental agencies for licensing, law enforcement, or security purposes, or in the interests of national security; and to
foreign and international governmental authorities in accordance with law and international agreement.
Disclosure: Furnishing this information is voluntary; however, failure to provide it will delay and may prevent completion
of your security threat assessment.

PAPERWORK REDUCTION ACT STATEMENT:
Statement of Public Burden: TSA is collecting this information to determine your eligibility for a TWIC. This is a voluntary
collection of information but failure to provide the information may result in an inability to approve your eligibility for a TWIC.
TSA estimates that the total average burden per response associated with this collection for enrollment is approximately 
minutes. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information
unless it displays a valid OMB control number. The control number assigned to this collection is OMB 1652-0047, which
expires 09/30/2013.

If you need assistance, please call 855-DHS-UES1 (855-347-8371) between 8am – 10pm EST Mon.-Fri.
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TWIC Replace Card
Enter Information

* Required fields

Unexpected error.
If the information you entered is inaccurate, please correct and click ‘Next’ to try again. If your information is
correct, please call 855-DHS-UES1 (855-347-8371) for more information.
Please enter your information below to determine if you are eligible for a card replacement or EED.
Then click ‘Next’ to continue.
*First Name

Middle Name

John

Steven

*Last Name

Suffix

Smith
*Gender

*Date of Birth

Male

12/30/1972

Preferred Language

English

December 30, 1972

*Method of Contact 1
Country Code

United States (+1)

Phone

615-123-4568

*Method of Contact 2
Method

*Primary Method of Contact

Method of Contact 1

Next
PRIVACY ACT STATEMENT:
Authority: The authority for collecting this information is 49 U.S.C. 114, 40113, and 49 U.S.C. 5103a.
Purpose: This information is needed to verify your identity and to conduct a security threat assessment to evaluate your
eligibility for a Transportation Worker Identification Credential.
Routine Uses: Routine uses of this information include disclosure to the FBI to retrieve your criminal history record; to TSA
contractors or other agents who are providing services relating to the security threat assessments; to appropriate
governmental agencies for licensing, law enforcement, or security purposes, or in the interests of national security; and to
foreign and international governmental authorities in accordance with law and international agreement.
Disclosure: Furnishing this information is voluntary; however, failure to provide it will delay and may prevent completion
of your security threat assessment.

PAPERWORK REDUCTION ACT STATEMENT:
Statement of Public Burden: TSA is collecting this information to determine your eligibility for a TWIC. This is a voluntary
collection of information but failure to provide the information may result in an inability to approve your eligibility for a TWIC.
TSA estimates that the total average burden per response associated with this collection for enrollment is approximately 26
minutes. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information
unless it displays a valid OMB control number. The control number assigned to this collection is OMB 1652-0047, which
expires 09/30/2013.

If you need assistance, please call 855-DHS-UES1 (855-347-8371) between 8am – 10pm EST Mon.-Fri.
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TWIC Replace Card
Select Reason

Extended Expiration Date (EED)
You are eligible to replace your TWIC with a three
three-year
year ex
extended expiration date (EED) TWIC for a reduced
fee of $60. If you would like to take advantage of this opportunity please select one of the reasons below that
offers the three-year extension. Click here for further information on EED TWICs.
Please select the reason for your card replacement. Then click ‘Next’ to continue.
Card is Lost/Stolen (TWIC expiration will be extended by 3 years)
Card is Damaged (TWIC expiration will be extended by 3 years)
Unable to Reset Card PIN (TWIC expiration will remain the same)
Extended Expiration Date (EED) (TWIC expiration will be extended by 3 years)

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TWIC Replace Card
Select Reason
Please select the reason for your card replacement. Then click ‘Next’ to continue.
Card is Lost/Stolen (TWIC expiration will remain the same)
Card is Damaged (TWIC expiration will remain the same)
Click here if you are looking for an Extended Expiration Date (EED) TWIC.

Back

Next

If you need assistance, please call 855-DHS-UES1 (855-347-8371) between 8am – 10pm EST Mon.-Fri.
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TWIC Replace Card
Select Reason
Please select the reason for your card replacement. Then click ‘Next’ to continue.
Card is Lost/Stolen (TWIC expiration will remain the same)
Card is Damaged (TWIC expiration will remain the same)
Click here if you are looking for an Extended Expiration Date (EED) TWIC.
According to our records, you are ineligible for an EED.
Reason: Only US Citizens and Nationals are eligible for EED.
If you feel this message is an error, please call 855-DHS-UES1 (855-347-8371).

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If you need assistance, please call 855-DHS-UES1 (855-347-8371) between 8am – 10pm EST Mon.-Fri.
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TWIC Replace Card
Select Reason
Please select the reason for your card replacement. Then click ‘Next’ to continue.
Card is Lost/Stolen (TWIC expiration will remain the same)
Card is Damaged (TWIC expiration will remain the same)
Click here if you are looking for an Extended Expiration Date (EED) TWIC.
According to our records, you are ineligible for an EED.
Reason: Your TWIC card expiration is beyond the EED validity period.
If you feel this message is an error, please call 855-DHS-UES1 (855-347-8371).

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Future OneVisit Selection Page*
*Currently under development, actual page may look different.

Select Pickup Option
How would you like to pick up your card?

Pick up at an enrollment center (Goes to Slide 14)
Directly shipped to my mailing address (Goes to Slide 15)

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TWIC Replace Card
Select Pickup Location
Enter a Postal Code or City to ‘Search’ for a location to pick up and activate your replacement card.

Search

Select the location. Then click ‘Next’ to continue.

Nashville, TN
15 Century Blvd.
Suite 500
Nashville, TN

Hours:
Mon & Wed & Thur: 9:00AM - 12:00PM & 1:00PM - 4:00PM
Tues & Fri: 9:00AM - 12:00PM & 1:00PM - 2:00PM
View Map

Decatur, AL
1436 Shoal Creek Road
Decatur, AL

Chattanooga, TN
6102 Shallowford Road
Ste. 102
Chattanooga, TN

Paducah, KY

Evansville, IN

Sign Up for Alerts

124.7 mi

Sign Up for Alerts

Hours:
Mon, Tues, Thur & Fri: 8:30AM - 11:30AM Wed: 8:30AM 11:30AM & 1:30PM - 4:30PM
View Map

113.6 mi

Sign Up for Alerts

Hours:
Mon - Fri: 9:00AM - 12:00PM & 12:30PM - 3:00PM
View Map

2532 Waterbridge Way
Evansville, IN

109.1 mi

Hours:
Mon, Tues, Thur & Fri: 8:30AM - 11:30AM Wed: 8:30AM 11:30AM & 1:30PM - 4:30PM
View Map

611 Broadway Street
Paducah, KY

Sign Up for Alerts

Hours:
Mon - Fri: 8:30AM - 4:30PM
View Map

1.8 mi

136.1 mi

Sign Up for Alerts

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If you need assistance, please call 855-DHS-UES1 (855-347-8371) between 8am – 10pm EST Mon.-Fri.
The use of the Universal Enrollment Services (UES), TWIC®, HME and HAZMAT names in connection with this website is with the express permission of the
Department of Homeland Security, Transportation Security Administration

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Future OneVisit Mailing Address Page*
*Currently under development, actual page may look different.

John Steven Smith
Apt. 15
123 Waterburry Way
Nashville, TN

37201

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TWIC Replace Card
Calculate Fee
If you have a coupon code, please enter it below and click ‘Apply’ to reduce your fee. Then click ‘Next’ to
continue.
Replace Card (TWIC expiration will be extended by 3 years)
Coupon Code

$60.00

Apply

Fee: $60.00
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If you need assistance, please call 855-DHS-UES1 (855-347-8371) between 8am – 10pm EST Mon.-Fri.
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TWIC Replace Card
Calculate Fee
If you have a coupon code, please enter it below and click ‘Apply’ to reduce your fee. Then click ‘Next’ to
continue.
Replace Card (TWIC expiration will be extended by 3 years)
Coupon Code

111HKV5511QK95

$60.00

Apply

Coupon Applied ($60.00)

Fee: $0.00
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TWIC Replace Card
Enter Credit Card Information

* Required fields

Please enter your credit card information below. Then click ‘Order’ to complete your transaction.
We Accept:

Total Amount Due:

$60.00

(non-refundable)

*Name on Card
John Smith
*Credit Card Number
4444657591231475
*Expiration Date
08

/

*CSC

14

152

Email Receipt To:

jsmith@comcast.net

Back

Order
Important: Do not attempt to click the ‘back’ button on your browser during processing.
Doing so may result in multiple charges to your account.

If you need assistance, please call 855-DHS-UES1 (855-347-8371) between 8am – 10pm EST Mon.-Fri.
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TWIC Replace Card
Confirm Order
Click ‘Order’ to complete your transaction.

Total Amount Due:

Back

$0.00
Order

Important: Do not attempt to click the ‘back’ button on your browser during processing.
Doing so may result in multiple charges to your account.

If you need assistance, please call 855-DHS-UES1 (855-347-8371) between 8am – 10pm EST Mon.-Fri.
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Service Status
Thank you for your order! Your transaction summary is below.

Print Status

Note: You will be notified within 10 days when your card is ready for pickup.
Payment Details:

Date:
Applicant:
UE ID:
Service:
Fee:
Paid:
Method:
Auth Number:

10/17/12 @ 11:03 AM
JOHN S SMITH
U11F-193H9F
TWIC REPLACE CARD
$60.00
$60.00
CARD (ending in 1475)
00041C

Pick-up Location Details:

Nashville, TN

Hours: Tuesday, Thursday - 1:00 PM - 5:00 PM CST

15 Century Blvd.
Suite 500
Nashville, TN

Facility is in the Postal Annex, next to Trader Joe's in Oak Grove Plaza shopping complex.
No truck parking available
View Map

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If you need assistance, please call 855-DHS-UES1 (855-347-8371) between 8am – 10pm EST Mon.-Fri.
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Service Status
Thank you for your order! Your transaction summary is below.
Note: You will be notified within 10 days when your card is ready for pickup.
Payment Details:

Date:
Applicant:
UE ID:
Service:
Fee:
Paid:
Method:

10/17/12 @ 11:03 AM
JOHN S SMITH
U11F-193H9F
TWIC REPLACE CARD
$60.00
$60.00
COUPON

Pick-up Location Details:

MorphoTrust

Hours: Tuesday, Thursday - 1:00 PM - 5:00 PM CST

15 Century Boulevard,
Suite 500,
Nashville, TN

Facility is in the Postal Annex, next to Trader Joe's in Oak Grove Plaza shopping complex.
No truck parking available

3.5 mi

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jsmith@comcast.net

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If you need assistance, please call 855-DHS-UES1 (855-347-8371) between 8am – 10pm EST Mon.-Fri.
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Note: You will be notified within 10 days when your card is shipped to your mailing address.

Delivery Mailing Address:

John Steven Smith
Apt. 15
123 Waterburry Way
Nashville, TN 37201