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If you make an error, complete a newform. Do not correct.  Reset   \n\n| SECTION 1. CHILD APPLYING FOR A U.S. PASSPORT\u003Cbr>Print your child’s name as it appears on the passport application (Form DS-11) and child’s birthdate. |  |  |  |  |\n| --- | --- | --- | --- | --- |\n| a.Child’s Name (LAST, FIRST MIDDLE) Example: SMITH, JOHN ROBERT |  |  | b. Child’s Birthdate (MM-DD-YYYY)  Check box if age 16 or 17 |  |\n|  |  |  |  |  |\n| \u003Cbr>\u003Cbr>SECTION 2. ADULT APPLYING IN PERSON WITH CHILD UNDER AGE 16\u003Cbr>\u003Cbr>Print name of adult appearing in person to apply for a U. S. passport and relationship to the above-named child. |  |  |  |  |\n| a. Applying Adult’s Name (LAST, FIRST MIDDLE) |  | b. Applying Adult’s Relationship to Child (Check one) |  |  |\n|  |  |  Legal Parent |  Legal Guardian |  Third Party |\n| SECTION 3. STATEMENT OF CONSENT FOR PASSPORT ISSUANCE TO THE CHILD\u003Cbr>In blank space 1 (and blank space 2, if applicable) below, print the full name(s) of the legal parent/legal guardian(s) who cannot appear in-person with the minor child to apply for the passport. Then complete the address and contact details in the boxes below. |  |  |  |  |\n| I/We, 1)  and 2)  , consent to the issuance of a United States passport to the minor child. I/We consent for the adult named in Section 2 to accompany the minor child and to execute the passport application if the minor child is under age 16. This consent is unconditional regarding passport validity and travel. This consent is valid for the issuance of a U.S. passport book and card\u003Cbr>unless otherwise stated in writing here  \u003Cbr>Example: “Issue passport book only” or “Issue passport card only” |  |  |  |  |\n| 1) Non-Applying Legal Parent/Guardian Address and Contact Details | 2) Non-Applying Legal Parent/Guardian Address and Contact Details Check box if same as 1 |  |  |  |\n| Street Address:   City, State/Country, Zip Code:   Phone:   Email:   | Street Address:   City, State/Country, ZipCode:   Phone:   Email:  |  |  |  |\n| \u003Cbr>\u003Cbr>SECTION 4. OATH/AFFIRMATION. STOP HERE! Do not sign this form until requested to do so by a Passport Authorizing Officer or Notary. This section must be signed by the affiant(s) named in Section 3 of this form. |  |  |  |  |\n| OATH: I solemnly swear (or affirm) that the above information given by me is true and correct to the best of my knowledge and belief. |  |  |  |  |\n| 1) Non-Applying Legal Parent/Legal Guardian Signature\u003Cbr>Date | 2) Non-Applying Legal Parent/Legal Guardian Signature\u003Cbr>Date |  |  |  |\n| 1) Non-Applying Legal Parent/Guardian Identifying Documents:\u003Cbr> Driver’s License  Passport  Military  Other  Name:   ID Number:   Place of Issue:   Issue Date:   Expire Date:   | 2) Non-Applying Legal Parent/Guardian Identifying Documents:\u003Cbr> Driver’s License  Passport  Military  Other  Name:   ID Number:   Place of Issue:   Issue Date:   Expire Date:   |  |  |  |\n| On the date specified above and below, the affiant(s) listed above who is/are not related to me, personally appeared before me and executed this consent for the uses and purposes therein contained. I have properly verified the identity of the affiant(s) by personally viewing the above-notated identification document(s) and matching photocopy(ies) .\u003Cbr>Passport Authorizing Officer or Notary Signature\u003Cbr>Date\u003Cbr>Location\u003Cbr>(Agency or City, State)\u003Cbr>\u003Cbr>SEAL |  |  |  |  |\n| Attach a clear photocopy of the front and back of the valid government-issued photo identification presented to the passport authorizing officer or notary. This consent is valid for 90 days from the passport authorizing officer or notary’s signed date. If this consent expires before submitting the U.S. passport application for the above-named child, new consent is required. |  |  |  |  |","cbCaiheeRHtePorb","https://ap.wps.com/l/cbCaiheeRHtePorb","pdf",3240620,"English","# Section 1: Child Applying for a U.S. Passport\n# Section 2: Adult Applying In Person With Child Under Age 16\n# Section 3: Statement of Consent for Passport Issuance to the Child\n## Non-Applying Legal Parent/Guardian Address and Contact Details\n# Section 4: Oath/Affirmation","[{\"question\":\"What information is required in Section 1 for the child?\",\"answer\":\"You must print the child’s name as it appears on the passport application (Form DS-11) and the child’s birthdate. Include any required check box for age 16 or 17.\"},{\"question\":\"Who completes Section 3 and what does it cover?\",\"answer\":\"Non-applying legal parent/legal guardian(s) who cannot appear in person must provide full names, address and contact details, and consent to issuance of a U.S. passport to the minor child.\"},{\"question\":\"When must the form be signed and by whom?\",\"answer\":\"Section 4 must be signed by the affiant(s) named in Section 3, after being requested by a Passport Authorizing Officer or Notary. The form also requires the officer/notary signature, date, and location.\"}]","DS-3053-2024 - U.S. Passport Consent for a Child | PDF",1789828710]