DS-3053 Child Passport Application

Form DS-3053

Download the DS-3053 Statement of Consent Application Form this fillable PDF document is used when parents would not be able to present the child passport application to the acceptance agent.

The State Department requires that parents or guardians fill out the DS-3053 Statement of Consent Application Form. You will need to get a witness and have the document notarized.

Requirements for DS-3053 Statement of Consent

  • You are a non applying parent or guardian providing a written consent for a minor U.S. citizan child to apply for a United States passport because you are unable to apply in person with your child (Statement of Consent) or
  • You are applying parent or guardian, and the written consent of a non applying parent or guardian

The PDF form DS-3053 must be printed and filled out using black ink. The instructions are included in the PDF file. It is recommended that the form be filled out completely and legibly, as incomplete forms or illegible writing can cause delays in application processing times.

Either Item 4a or Item 5 must be filled out on this form. Item 4a, Statement of Consent, must be filled out by the parent giving express written consent to issue a passport to a minor child. Item 5, Statement of Special Circumstances, must be filled out by the applying parent if the written consent of the non-applying parent can not be obtained. If item 4a was filled out, this form must be signed, dated and notarized, If item 5 was filled out, this form must be signed and dated; no notarization is necessary.

Form DS-3053 must be submitted along with form DS-11 at an approved passport agency or acceptance facility within 3 months of the date it was notarized. Any future Statement of Consent from the non-applying parent must be notarized as well.

Processing time for passports is approximately four to six weeks. Expedited child passport processing options are available for additional fees.

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