Form DS-3053: Statement of Consent: Issuance of a U.S. Passport to a Minor Under Age 16

About this Form:

Form DS-3053 is used to gather the information necessary is to establish two parent consent for a minor's passport application.

How do I fill out Form DS-3053?

The purpose of Form DS-3053 is when a minor under the age of 16 applies for a passport and one parent or legal guardian is not available to be present when the passport is executed. This form should be completed, notarized, and used as the statement of consent. Starting at the top of the page with field 1, enter the minor’s last name, first name, and middle name. Moving down, enter the minor’s date of birth in field 2. The format is two-digit for the month and day, and four-digits for the year. If your birthday is March, 16, 2010, the date should be written as 03/16/2010. In field 3, check the box if the minor needs a passport book and card, book only, or card only. Moving to field 4, starting on the first line, enter the parent or legal guardian’s name who is not applying and will be there when the passport is executed. On the second line, enter the parent or legal guardian’s name of the person who is applying and is not available to be present when the minor applies for a passport. Moving to the middle of field 4, enter the address of the parent or guardian who is not applying, apartment or suite number is applicable, city, state, and zip code. Down to the next line, enter your best contact number, including area code and a current email address. Stop here. Your signature must be witnessed and notarized in field 5.  

Form DS-3053: Statement of Consent: Issuance of a U.S. Passport to a Minor Under Age 16: FAQs

  • Form DS-3053 is used to gather the information necessary is to establish two parent consent for a minor's passport application.

  • Form DS-3053 needs to be filled when a minor under the age of 16 applies for a passport and one parent or legal guardian is not available to be present when the passport is executed.

  • Form DS-3053 should be completed, notarized, and used as the statement of consent.

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