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This version of the form is not currently in use and is provided for reference only. Download this version of
Form DS-3053
for the current year.
Form DS-3053 Statement of Consent: Issuance of a U.S. Passport to a Minor Under Age 16
What Is Form DS-3053?
Form DS-3053, Statement Of Consent: Issuance Of A U.S. Passport To A Minor Under Age 16 , is a supplemental document filled out by the minor's parents or legal guardians to authorize the issuance of a U.S. passport to the indicated minor if they cannot be present when the passport is executed.
Alternate Name:
- Passport Form DS-3053.
This document must be submitted along with Form DS-11, Application for a U.S. Passport, to provide the child with authorization to receive a passport book or passport card. File the DS-3053 Form with any U.S. embassy, passport agency, consulate, or other designated acceptance facility. This is the best way to authorize the issuance of the minor's passport if the parents are unable to appear in person when the child submits the passport application for whatever reason.
This form was released by the U.S. Department of State (DS). The latest version of the form was issued on August 1, 2016 , with all previous editions obsolete. You can download a DS-3053 fillable form through the link below.
Form DS-3053 Instructions
Follow these steps to fill out Passport Form DS-3053:
- Identify the minor by their full name and date of birth.
- Check the reason for giving an authorization - you give your consent for the issuance of the passport book, passport card, or both documents at the same time.
- Provide your statement of consent by adding your full name and name of the minor and writing down your physical address, telephone number, and e-mail address.
You cannot sign the form before you appear in front of a notary public or obtain authorization at a U.S. embassy or consulate that provides certified notarial services free of charge. Once the notary confirms your identity by checking your government-issued photo identification, you are allowed to sign and date the form certifying the statements made in the document are correct and true. The notary will write down their name, location, date when their commission expires, and sign the statement.
The written consent is valid for ninety days from the date of obtaining the notary seal. A new consent form is mandatory for future applications if you fail to submit the documentation within three months.
In addition to Form DS-11 and Form DS-3053, you might have to present evidence of the minor's U.S. citizenship and proof of the child's relationship to you - usually, a birth certificate is enough. If you represent an entity or institution that was granted guardianship, along with this form, you also need to submit these three documents:
- A copy of the identification documents that show you work at the institution.
- Letterheaded statement from the entity or institution that authorizes you to apply for a passport book or card on the minor's behalf. It must contain the child's name, the name of the person authorized to apply, and the signature of the institution's director or administrator.
- Original copy of the certified court order that grants guardianship to the entity.
Download Form DS-3053 Statement of Consent: Issuance of a U.S. Passport to a Minor Under Age 16
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