Form DS-3053, Statement of Consent: Issuance of a Passport to a Minor under Age 14
Form DS-3053 is required to be filed by a U.S. citizen, parent or legal guardian(s). Form DS-3053 is required to be notarized and submitted together with Form DS-11.
Individuals that do not provide correct information may face consequences including refusal and denial of a U.S. passport, fines and/or imprisonment. Form DS-3053 can be completed on your computer by using Adobe Reader before printed. Form DS-3053 (Statement of Consent) may also be known as Department of State Passport Form DS3053, DS 3053, Form DS3053 or immigration form DS-3053.
Form DS3053 is included in the following application guides:
This immigration form is available for free at United States government websites.