[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-305227-105":53,"doc-detail-305227-en":127},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":120,"head_meta":122,"extra_data":124,"updated_unix":126},105,"en","statement-of-consent-form-ds3053","Statement-of-Consent-Form-ds3053","","Instructional consent statement form for a U.S. passport when one or both legal parents or legal guardians cannot appear in person with the child. Requires notarized consent or a written statement containing all required details, valid under specified age-related conditions, and subject to expiration 90 days after notarization. Includes submission requirements such as notarized signatures, identification photocopies, and court-ordered guardianship documentation. Contains warnings about knowingly false statements and explains related privacy and paperwork reduction act notices.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/statement-of-consent-form-ds3053/305227/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/statement-of-consent-form-ds3053/305227.png","ImageObject",442,249,{"name":88,"@type":89},"Chumphorn","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-14","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",10,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"When is this DS-3053 consent form used?","Question",{"text":109,"@type":110},"It is used when one or both legal parents/legal guardians cannot apply in person with the child for the child’s passport. Consent can be given using this form or a written statement with all required information, which must be notarized.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"How long is a notarized consent statement valid?",{"text":114,"@type":110},"Consent statements expire 90 days after the date of notarization.",{"name":116,"@type":107,"acceptedAnswer":117},"What additional documents are required for institutions or entities with guardianship?",{"text":118,"@type":110},"Submit a certified court order granting guardianship, a signed institution/entity statement authorizing a specific person to apply (on letterhead, naming the child and authorized applicant[s]), and a photocopy of employee identification proving the applicant works at the institution/entity.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},305227,1790446629,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":73,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":9},2336475401981,"https://ap-avatar.wpscdn.com/avatar/22000c94efd8d5204d?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786935347598174694","Please Print Legibly Using Black Ink Only. If you make an error, complete a new form. Do not correct.  \n\n| USE OF THIS FORM |\n| --- |\n| 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.\u003Cbr>􀁸  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.\u003Cbr>􀁸  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 ora 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) . |\n| IMPORTANT |\n| • If \\#3 on page two is not completed, consent will be valid for both passport book and card.\u003Cbr>• Statements of consent expire 90 days after the date of notarization.\u003Cbr>• You must submit a photocopy of the front and back of the identification you presented to the notary.\u003Cbr>• You must sign the statement of consent in front of a notary.\u003Cbr>• The date of the notary's signature must be the same as the date of your signature.\u003Cbr>• 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. |\n| INSTITUTIONS/ENTITIES GRANTED GUARDIANSHIP |\n| You must submit all of the following with this form:\u003Cbr>1. A certified court order granting guardianship to the institution/entity. Photocopies are not acceptable.\u003Cbr>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.\u003Cbr>The statement must include the child's name and the name of the individual(s) authorized to apply for the passport.\u003Cbr>3. A photocopy of employee identification documents proving the person applying for the child's passport works at the institution/entity.\u003Cbr>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. |\n| WARNING |\n| False statements made knowingly and willfully on passport applications, including affidavits or other supporting documents submitted therewith, may be punishable [by fine and/or imprisonment under U.S. law](by fine and/or imprisonment under U.S. law), including the provisions of 18 U.S.C. 1001, 18 U.S.C . 1542, and/or 18 U.S.C. 1621. |\n| FOR INFORMATION AND QUESTIONS |\n| For passport and travel information, please visit [travel.state.gov. In](travel.state.gov. In) addition, contact the National Passport Information Center (NPIC) toll-free at 1-877-487-2778 (TDD/TTY 1-888-874-7793) or by email [at](at NPIC@state.gov. For)[ ](at NPIC@state.gov. For)[NPIC@state.gov](at NPIC@state.gov. For)[. For](at NPIC@state.gov. For) information on International Parental Child Abduction, please visit [travel.state.gov/childabduction](travel.state.gov/childabduction) or contact the Office of Children's Issues by telephone at 1-888-407-4747 or by email [at PreventAbduction1@state.gov](at PreventAbduction1@state.gov). |\n| P","cbCaigEV3hEloGAl","https://ap.wps.com/l/cbCaigEV3hEloGAl","pdf",831499,"English","# Use of This Form\n# Important Requirements\n# Institutions/Entities Granted Guardianship\n# Warning on False Statements\n# For Information and Questions\n# Privacy Act Statement\n# Paperwork Reduction Act Statement","[{\"question\":\"When is this DS-3053 consent form used?\",\"answer\":\"It is used when one or both legal parents/legal guardians cannot apply in person with the child for the child’s passport. Consent can be given using this form or a written statement with all required information, which must be notarized.\"},{\"question\":\"How long is a notarized consent statement valid?\",\"answer\":\"Consent statements expire 90 days after the date of notarization.\"},{\"question\":\"What additional documents are required for institutions or entities with guardianship?\",\"answer\":\"Submit a certified court order granting guardianship, a signed institution/entity statement authorizing a specific person to apply (on letterhead, naming the child and authorized applicant[s]), and a photocopy of employee identification proving the applicant works at the institution/entity.\"}]","Statement-of-Consent-Form-ds3053 | PDF",1789823002]