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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-10
for the current year.
Form DS-10 Birth Affidavit
What Is a Birth Affidavit (DS-10)?
Form DS-10, Birth Affidavit , is a legal document completed to prove the birth of an individual in a U.S. territory, in order to obtain a U.S. passport when an acceptable birth certificate is not available. Use this form if you do not possess your original birth certificate or documentation that confirms naturalization, have no access to your birth records for any reason, or the birth records are insufficient, but you have to apply for a U.S. passport.
This affidavit is filled out by an individual who has personal knowledge about the applicant's birth in the U.S. Usually, it is a blood relative who was present at the time of birth - aunt, uncle, sibling, or grandparent. You can also collect information from the attending doctor, midwife, or the adoptive parent who witnessed the birth. A properly filled out affidavit will provide evidence to establish the applicant's identity and U.S. citizenship proving these facts the same way a usual birth certificate does.
This form was released by the U.S. Department of State (DS). The latest version of the form was issued on July 1, 2017 , with all previous editions obsolete. You can download a fillable DS-10 Form through the link below.
Form DS-10 Instructions
Provide the following details in the Affidavit of Birth:
- Full name of the individual whose birth you are proving, their sex, date, and place of birth, and current physical address.
- State for how many years you have known the applicant and describe your relationship to this individual.
- List all the facts you know about the applicant's birth. You can record the time and location of birth, identify people present, and add other information about the event. Name the applicant's birth parents and your relationship to them. It is enough to write down a brief statement but if you require more space, you may attach separate sheets of paper to indicate more details.
- Enter your name, social security number, date of birth, address, and sign the affidavit. You can only sign the form in the presence of a notary public, passport agent, or acceptance agent who will check your identifying document and affix the notary seal. Once you take an oath certifying the statements in the affidavit, you may sign the document.
Once the affidavit is signed, give it to the person who is applying for the U.S. passport. Then, the applicant will submit Form DS-10 along with other required documentation. Include a written statement from the relevant authority that confirms that no birth record or certificate exists. If you have access to other public records, for instance, physician's records, baptismal certificates, census records, or family Bible records, you may present them as well to add more weight to the affidavit.
Download Form DS-10 Birth Affidavit
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