Statement of Consent: Issuance of a U.S. Passport to a Child

This form is used when one or both legal parents and/or legal guardians cannot apply in person with the child for that child's passport. The legal parent/legal guardian who cannot apply with the child can give consent using this form or a written statement that includes all of the information on this form. This form or the written statement must be notarized. If the required consent is not submitted, the child may not be eligible for a U.S. passport.

• For children under the age of 16: Both legal parents/legal guardians must apply for the passport with the child or the legal parent/legal guardian that cannot apply with the child must complete and notarize this form to be submitted with the application.
• For children 16 or 17 years old: The Department may request the consent of one legal parent/legal guardian to the issuance of a passport to an applicant who is 16 or 17 years of age. In many cases, the passport authorizing officer may be able to ascertain parental awareness of the application by virtue of the parent’s presence when the minor submits the application or a signed note from the parent or proof the parent is paying the application fees. However, the passport authorizing officer retains discretion to request the legal parent’s/legal guardian’s notarized statement of consent to issuance (e.g., on Form DS-3053).

• If #3 on page two is not completed, consent will be valid for both passport book and card.
• Statements of consent expire 90 days after the date of notarization.
• You must submit a photocopy of the front and back of the identification you presented to the notary.
• You must sign the statement of consent in front of a notary.
• The date of the notary's signature must be the same as the date of your signature.
• This form can also be used to authorize a third party to apply for a child's passport on behalf of the legal parents/legal guardians who cannot apply in person.

You must submit all of the following with this form:

1. A certified court order 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 the child's behalf. The statement must include the child'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 child's passport works at the institution/entity.

Please ensure that none of the above documents has any conditions placed on the period of validity of the passport or where the child may travel. If there are conditions in the statement, a new statement of consent is required.