Printable blank DS-3053 Form

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What is DS-3053?

The DS-3053 form is used if a minor (a person under the age of 16) applies for a passport, and one of their parents/guardians cannot be present. The non-present guardian must give permission by filling out the consent and sending it along with the DS-11 form. A photocopy of the non-present parent/guardian front and back government-issued ID must be transferred to the notary.

What I need the DS-3053 for?

DS-3053 is when one of the parents or guardians is not able to personally submit the completed application for the child at the appropriate facility. This form also requires the signature before getting notarized. The DS-3053 form is valid only for 90 days after the filling date.

Filling out DS-3053

To complete a Form DS-3053 Statement of Consent: Issuance of a U.S. Passport to a Minor Under Age 16, you must fill in the following information:

1. Last, First, and Middle names;

2. Date of birth;

3. Indication whether you need a passport in the form of a book and a card, or a book/card only;

4. Non-applying parent/guardian’s statement of consent must include the following information:

  • Their name;
  • Name of the parent/guardian applying for the minor's passport;
  • The non-applying person’s address;
  • Telephone number and/or e-mail address.

5. Notarization of consent permission

  • Notary name;
  • Location (address);
  • The expiration date;
  • Notary seal;
  • Non-applying person’s ID;
  • ID number;
  • Place and date of issue;
  • Signature and date of notarization.

Organizations that work with DS-3053

The following form is accepted in:

U.S. Passport Agency.

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