Fillable Forms - US Department Of State. All the forms. Nonimmigrant Visa Applications. Form, Description. Nonimmigrant Visa Application. Statement of Consent - Issuing a Passport to a Minor Under Age 16. FORM INSTRUCTIONS 1. Complete items 1, 2, and 3. Complete item 4a, Statement of Consent, only if you are a non-applying parent or guardian consenting to the issuance of a. DS-30 Page 1 of 2 Driver’s License Passport Military Identification Other (specify) Place of Issue.
![]() Form DS-3053
The information collected on this form is used in conjun ction with the DS-11, 'Application for a U.S. Passport.' When a m inor under the age
of 16 applies for a passport and one of the minor's parents or legal guardians is unavailable at the time the passport is executed, a completed
and notarized DS-3053 can be used as th e statement of consent. If the required sta tement is not s ubmitted, the minor may not be eligible to
receive a U.S. passport. The required statement may be submitted in other formats provided they meet statutory and regulatory
USE OF THIS FORM
For passport and travel in formation, please v i sit o ur website at travel.state.gov. In addition, contact the National Passpo rt Information C enter (N PIC )
toll-free at 1-877-487-2778 (TDD 1-888-874-7793) or by e-mail at [email protected]
Monday-Friday, 8:00 a.m. - 10:00 p.m. Eastern Standard Time (excluding federal holidays). Automated information is available 24/7.
For information on International Parental Child Abduction, please visit www.travel.state.gov/childabduction
Issues by telephone at 1-888-407-4747 or by e-mail at [email protected]
1. Complete fields 1, 2, and 3. If field 3 is not completed, authorization will be valid for both products.
2. Complete field 4, Statement of Consent, only if you are a non-applying parent or guard ian consenting to the issuan ce of a passport for your minor
child. NOTE: Your signature must be witnessed and notarized in field 5.
3. The written consent from the non-applying parent that accompanies an application for a new U.S. passport must not be more than 90 days old.
A clear photocopy of the front and back of the non-applying parent's government-issued photo identification presented to the notary is required
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4. Please submit this form with your minor child's new DS-11 passport application to any designated acceptance facility, U.S. Passport Agency, U.S.
STATEMENT OF CONSENT:
ISSUANCE OF A U.S. PASSPORT TO A MINOR UNDER AGE 16
WARNING: False statements made knowingly and willfully on passport applications, including affidavits or other supporting documents
submitted therewith, may be punishable by fine and/or imprisonment under U.S. law, including the provisions of 18 U.S.C. 1001, 18 U.S.C.
FOR INFORMATION AND QUESTIONS
Public reporting burden for this collection of information is estimated to average 20 minutes per response, including the time required for searching
existing data sources, ga thering the necessary data, providing the information and/or documents required, and reviewing the final collection. You do
not have to supply this information unless this collection displa ys a currently valid OMB co ntrol numbe r. If yo u hav e comments on the accuracy of this
burden estimate and/or recommendations for reducing it, please send them to: U.S. Department of State, Bureau of Consular Affairs, Passport
Services, Office of Legal Affairs and Law Enforcement Liaison, Attn: Forms Officer 44132 Mercure Cir, P.O. Box 1227, Sterling, Virginia 20166-1227.
AUTHORITIES: We are authorized to collect this information by 22 U.S.C. 211a et seq.; 8 U.S.C. 1104; 26 U.S.C. 6039E; Executive Order 11295
PURPOSE: The primary purpose for soliciting the information is to establish two parent consent for a minor's passport application, as required by
ROUTINE USES: This information may be disclosed to another domestic government agency, a private contractor, a foreign government agen c y, or t o
a private person or private employer in accordance with certain approved routine uses. These routine uses include, but are not limited to, law
enforcement activities, employment verification, fraud prevention, border security, counterterrorism, litigation activities, and activities that meet the
Secretary of State's responsibility to protect U.S. citizens and non-citizen nationals abroad. More information on the Routine Uses for the system can
be found in System of Records Notices State-05, Overseas Citizen Services Records and State-26, Passport Records.
DISCLOSURE: Failure to provide the information requested on this form may result in the refusal or denial of a U.S. passport application.
Below is a list of documents you must submit with your DS-3053:
ertified order of a court of competent jurisdiction granting guardianship to the institution/entity. (Photocopies are not acceptable.)
2. A signed statement from the institution/entity on letterhead authorizing a specific person to apply for a passport for the child on its behalf. The
statement must include the minor's name and the name of the individual(s) authorized to apply for the passport.
3. A photocopy of employee identification documents proving the person applying for the minor's passport works at the institution/entity.
SPECIAL REQUIREMENTS FOR INSTITUTIONS/ENTITIES GRANTED GUARDIANSHIP
PRIVACY ACT STATEMENT
Please ensure that all of the above do NOT have any conditions placed on the period of validity of the passport or where the minor may travel. If there
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are conditions in the statement, a new statement of unequivocal consent is required.
3. THIS AUTHORIZATION IS VALID FOR:
to apply for a United States passport for my minor child named on this application. My consent is unconditional in regards to passport validity and travel.
STOP! YOU MUST SIGN THIS FORM IN FRONT OF A NOTARY.
FirstMiddle
Last
4. STATEMENT OF CONSENT To be completed by the non-applying parent or guardian using his/her information when not
present at the time the applying parent or guardian submits the minor's application. Statements expire after 90 days.
OATH: I declare under penalty of perjury that all statements made in this supporting document are true and correct.
Date (mm/dd/yyyy)Signature of Non-Applying Parent or Guardian
Name of Notary
City, State
Date (mm/dd/yyyy)
NOTARY
Date of
Date (mm/dd/yyyy)
by Non-Applying Parent or
PassportMilitary IDDriver's LicenseOther (specify)
Place of Issue:ID Number:
ISSUANCE OF A U.S. PASSPORT TO A MINOR UNDER AGE 16
OMB EXPIRATION DATE: 08-31-2019
DS-3053 08-2016
Attention: Read WARNING and FORM INSTRUCTIONS on Page 1
: A clear photocopy of the front and back of the identification you presented to the notary is required with this form.
OATH: By signing this document, I certify that I am a licensed notary under laws and regulations of the state or country for which I am
performing my notarial duties, that I am not related to the above affiant, that I have personally witnessed him/her sign this document, and
that I have properly verified the identity of the affiant by personally viewing the above notated identification document and the matching
Street Address (non-applying parent)
Telephone NumberE-mail Address
()
I,
Print Name (Notary Public)
Print Name (person applying for minor's passport)
DS 3053 FILLABLE PDF
Download the DS Statement of Consent Application Form this fillable PDF document is used when parents would not be able to present the child passport. Fill consent form eforms instantly, download blank or editable online. Sign, fax and printable from PC, iPad, tablet or mobile. No software. Try Now!. Fill Ds Fillable, download blank or editable online. Sign, fax and printable from PC, iPad, tablet or mobile with PDFfiller ✓ Instantly ✓ No software. Try Now!.
Submit form DS form ifllable with DS form Once all detail filling and its entirety were done, the person shall now proceed to submission of the form in person and both parents and guardians should appear with the child. It is a conjunction of the passport application form which is normally given first and what usually were handled to adults.
You will need to get to get sole physical custody of the child to apply without the DS form.
We don’t have an option to pay online. How to Edit DS Form. My husband is in Mexico, and I want to travel with my newborn but I need the DS if he faxes it to me would da work?
How can we help? Can he fillablee it to me and I print it and take it to post office? But to be sure it is best that you go to the U. Passport Help Guide says: Department of State of the views or products contained therein. Remember that the consent must no longer be older than 90 days.
DS-3053: Statement of Consent or Special Circumstance for a Minor Passport
What an else do we need to bring? I am filling out the form DS to get her passport. You are about to leave travel. If proven that it was a false detailed form, the application can be denied and it will be hard to file it again. A non-applying parent should fill this out. D the validity period is exceeded, you will need to re-take the new form from the State Department website.
The other parent has tried all she could to get in contact with the departed family member,but they are not really trying to help with the renewal of the passport.
Proof of relationship to the non-applying parent What Is DS Form Parents must be always there during many kinds of events in our lives, especially into our kids.
DS – Child Passport Application Form
They all had minor passports issued in When printing the application, make sure the image of the application covers the entire page. My husband is overseas, and I was wondering if it was possible for him to sign and notarize form DS and fax it to me or send me a copy of my email. I am applying a for a renewal passport for my daughter. During the filing dd, filling out the form ds should be taken care of accurately.
Yes, as long as it is certified notary it should work.
Because your son is 16 years old he would be able to apply for a new adult passport and would not need the ds application form. Passport You may fill out these forms using an online form filler or by downloading a PDF of the application and handwriting on it in black ink.
Will they accept a copy of the notarized form? You will need her mother to come along to sign the DS Application Form to renew the child passport. When I first got her passport, her mother came with us for the DS consent. We recommend the online form filler which is easier to complete. This is our second child who was born in France not sure if this changes anthing. Me and my daughters father have never been married. We recommend you go to the U.
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