Ds 5528-2026

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The document is an evacuation application and promissory note issued by the U.S. Department of State, requiring adult applicants to provide personal information for evacuation purposes. It outlines the responsibilities of evacuees, including repayment terms for transportation costs, and includes sections for emergency contacts and accompanying individuals. The document also contains privacy act statements and instructions for consular officers.

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Begin with Part 1, where each adult applicant must fill in their personal details. Start by entering your last name, first name, and middle name clearly.
Next, provide your Social Security Number and Date of Birth in the specified format (DD-MMM-YYYY). Include your place of birth and identity document information.
Fill in your current lodging address and contact information, including phone number and email address. Ensure all entries are accurate for effective communication.
Continue to list any medical conditions relevant to evacuation and provide a verifiable billing address at your final destination.
For accompanying minors or incapacitated adults, complete the respective sections with their details as required.
In Part 2, read through the Promissory Note carefully before signing. Acknowledge your understanding of repayment terms by providing your signature and date.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (119 Votes)
2016	3.7 Satisfied (33 Votes)
2013	4.4 Satisfied (57 Votes)

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What if Im not in the evacuation zone?

Stay Indoors: If you cannot evacuate, stay inside a sturdy building away from windows and doors. Use a Safe Room: If available, go to an interior room or hallway on the lowest floor, ideally a room without windows. Secure Windows and Doors: Use plywood or storm shutters to protect windows.

What must be taken with you in the case of evacuation?

Emergency evacuation packing list Pack your items in crates or bags you can easily carry. Include food and water for everyone in your household. Pack a change of clothes for up to a week and personal hygiene items. Bundle up what youll need for the little ones. Dont forget your pets.

What happens if you cant evacuate?

Contact your local emergency management agency for assistance. Call or text 911 for immediate assistance. Your neighbors are your lifeline. Let them know if you need assistance to evacuate.

Can the government make you evacuate?

Almost every year people along coastlines evacuate before hurricanes. If an official government source advises you to evacuate, do so immediately. Only when theres a serious threat to public safety is a mandatory evacuation ordered.

What to do if I cant evacuate?

If youre in an evacuation zone and lack gas, look into transportation to a shelter tomorrow, the earlier the better. See if you can get an uber, Lyft or taxi. See if local buses have the shelters on their routes. Call local info hotlines (be patient - youll be on hold awhile since lots of people need info).

form ds 5528

Ds 5528 pdf Ds 5528 evacuee manifest State Department evacuation America evacuation Office of Overseas Citizens Services

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What happens if you refuse to evacuate?

If you are not in any of the zones or structures asked to evacuate, you may stay at home if you feel safe doing so. Be sure to have a fully stocked emergency kit, prepare your residence to weather the storm, ensure others (family or friends) know your plan and follow all preparedness messages from local officials.

Will the US evacuate green card holders?

In general, we do not provide evacuation assistance to non-U.S. citizens. Exceptions may be made to accommodate special family circumstances, such as when a spouse or other relative of a U.S. citizen is traveling with the U.S. citizen family member.