DS-3053 Statement of Consent for a Child’s U.S. Passport

When this form is used

• One parent or legal guardian cannot appear with a child under age 16.
• Both parents authorize a third party to apply with the child.
• Passport Services requests written parental awareness for a 16- or 17-year-old.

What to have ready

• The child’s name and birth date exactly as shown on Form DS-11.
• The applying adult’s full name and relationship to the child.
• The non-applying parent or guardian’s address, phone, and email.
• A valid government-issued photo ID and a clear photocopy of the front and back.

Important completion notes

• Complete Sections 1, 2, and 3 before the session.
• Do not sign Section 4 before appearing before the notary.
• The signing date and the notary’s date must match.
• The consent is valid for 90 days from the notarization date.
• Some parents outside the United States must use a U.S. embassy or consulate instead of a local or remote notary.