Statement of Consent or Special Circumstance for Minor Passport is when one parent is applying for a passport for a child without the other parent or has sole custody of the minor.
Form DS-3053, Statement of Consent: Issuance of a U.S. Passport to a Minor Under Age 16, is used by the parent or guardian of a minor to give consent for the issuance of the minor’s passport. This form should be completed if one parent or legal guardian cannot accompany the minor at the time of application.
You may apply for a passport if you have the following documents:
Form DS-11 is used when applying for their first passport. It is used by U.S. citizens and U.S. nationals. This form can also be used by individuals who misplaced their passports, people who changed their names, or have not had a passport for over 15 years.
Birth or naturalization certificate.
A photo ID issued by the government such as a driver’s license or a military ID.
A 2x2” colored passport photo.
Your payment for the applicable fees.
Form DS-3053 is used when only one of the parents or legal guardians can accompany the minor at the time of application for a passport. The statement of consent must be given by the accompanying guardian. If the required consent is not submitted, the minor may not be able to acquire a passport.
WHEN FILLING OUT FORM DS-3053, THESE INSTRUCTIONS MUST BE FOLLOWED:
THESE ARE THE SPECIAL REQUIREMENTS FOR INSTITUTIONS/ENTITIES GRANTED GUARDIANSHIP
These are the required documents that you must submit with the DS-3053:
Make sure that the documents above do NOT have any conditions on the validity period of the passport or where the minor is allowed to travel. If there are specified conditions on the statements, a new statement of clear consent is required.
A warning is stated on this form that you should not enter any false information as it may lead to punishments and imprisonment under U.S. law.
FOR INFORMATION AND QUESTIONS
There are specific websites and contact numbers provided on the form should you have any questions or clarifications regarding passports or travel information.
You may visit the official website of the U.S. Department of State.
Contact the National Passport Information Center at 1-877-487-2778 or you may email them at [email protected]
If you want information regarding International Parental Child Abduction, visit travel.state.gov/child abduction or contact the Office of Children’s Issues on their telephone number 1-888-407-4747 or email them at [email protected]
WHEN YOU ARE FILLING OUT FORM DS-3053, YOU ARE UNDER THE PROVISIONS OF THE FOLLOWING LAWS
PRIVACY ACT STATEMENT
The privacy act is presented on this form to ensure that all the information and documents that you have provided will be used for legal purposes only.
The Department of State is authorized to collect this information.
The purpose of gathering the information provided is to establish two parent/guardian consent for a minor’s passport application.
The information may be shared with other domestic government agencies or any other authorized offices that may need to use this information for important purposes.
If you fail to provide the necessary information requested on the form may result in refusal or denial of the U.S. passport application.
PAPERWORK REDUCTION ACT STATEMENT
The estimated time of response for the public reporting burden of collecting the information collected is about 20 minutes. That includes all the necessary steps in reviewing the form and the provided documents for the application.
Enter the name of the minor you are applying a passport for using the following format: Last, First, Middle.
Enter the date of birth of your minor using the following format: Month-Date-Year
You may choose from the following options:
This section is to be filled out by the non-applying parent or guardian when he/she is not present at the time when the applying parent submits the minor’s application.
Enter your name.
Printed Name of applying parent/guardian
Enter the name of the parent/guardian you are authorizing to apply on behalf of the minor.
Enter your street address.
Enter the name of your apartment if applicable.
Enter the city where your address is located.
Enter the state.
Enter the zip code.
Area Code and Telephone Number
Enter the area code first, then your telephone number.
Enter your email address if it is available.
This section must be completed in front of a notary
By signing this form, you are declaring that all the information you have entered on this form is true and correct.
Signature of non-applying parent/guardian
Enter your signature.
Enter the date when this form is signed using the following format: Month-Day-Year.
A front and back photocopy of the identification you presented the notary must be presented on this form.
This part is to be filled out by the notary.
Name of Notary
Enter your name.
Enter the location of your office.
Enter the date when your commission expires using the following format: Month-Day-Year.
Provide the seal.
Identification Presented by Non-Applying parent/guardian
You may choose from the options provided regarding the identification that is presented to you. You may choose: Driver’s License, Passport, Military ID, or if the identification provided is not among the choices, indicate what type of identification the non-applying parent/guardian has provided.
Enter the number of the identification provided.
Place of issue
Enter the place where the identification was issued.
Enter the date when the identification was issued using the following format: Month-Day-Year.
Enter the date when the identification will expire using the following format: Month-Day-Year.
By signing the document, you are certifying that you are a licensed notary and that you are not related to the affiant, and you have personally witnessed him/her sign the document. The oath also states that you have verified the identity of the non-applying parent/guardian.
Signature of notary
Enter your signature.
Date of Notarization
Enter the date when the document is notarized using the following format: Month-Day-Year.
Keywords: DS 3053 Form DS 3053 state form DS 3053 DS 3053 consent for minor ds 3053 passport for minor passport form ds 3053 state form consent ds 3053 fillable