Absent Parent Passport Form

Absent Parent Passport Form
This form is used when one or both of the legal parents and/or legal heirs are unable to personally apply for that child's passport with the child.
Child's Name
First NameMiddle NameLast Name
Child's Date of Birth
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Is Child Under 16 Years Old?
Name of Adult Who Applied With The Child
First NameMiddle NameLast Name
This Consent Valid For:
First Name   Last Name   give my consent to the issuance of a United States passport to the minor child named on this application. My consent is unconditional with regards to passport validity and travel.
Adress: Street Address   Address Line 2   City   State   Zip
Phone Number: Area Code   Phone Number
Email:  Email
I declare under penalty of perjury that all statements made in this supporting document are true and correct.
Signature
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Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: