Dorian Mayhew Rothschild 60 Arthur St. San Rafael, CA 94901 May 08, 2012 U.S.

Department of State Passport Services Consular Lost/Stolen Passport Section 1111 19th Street, NW, Suite 500 Washington, DC 20036 Re: Report Lost Passport Dear Sir or Madam: This letter confirms the conversation I had with Daniel Klein at the U.S. Department of State headquarters on May 03, 2012. My passport was lost on or about April 09, 2012 at 3:00 pm in Berlin, Germany. I gave the following personal information to the local passport office: Name: Dorian Mayhew Rothschild Address: 60 Arthur St. San Rafael, CA 94901 Gender: Male Place of Birth: San Rafael Date of Birth: May 26, 1988 Passport Number: D1432886 Issue Date: August 15, 2008 Location of Passport Agency: San Francisco, CA My passport was lost under the following circumstances: I noticed my passport was missing when the hostel that I was staying at requested it in order to make a copy of it. Enclosed is a copy of the U.S. Department of State Form DS-64 Statement Regarding Lost or Stolen Passport.

Please contact me at the above address if you have any questions or need additional information. I can be contacted by phone at (415) 845-1654 (preferred) or (415) 123-5763 (alternate). Thank you for your prompt attention to this matter.

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Sincerely,

______________________________________ Dorian Mayhew Rothschild

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