Information Collection

Statement of Consent: Issuance of a U.S. Passport to a Minor Under the Age 16

IC 14999 under ICR 201306-1405-002 · OMB 1405-0129.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0129 can be found here:

Documents and Forms

Document Name Document Type
Form DS-3053 Statement of Consent: Issuance of a U.S. Passport to a Minor Under the Age 16 Form and Instruction
DS-3053 Statement of Consent: Issuance of a U.S. Passport to a M DS-3053.pdf Form and Instruction
DS-3053 Statement of Consent: Issuance of a U.S. Passport to a M DS-3053 (08-2013 rev).pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Statement of Consent: Issuance of a U.S. Passport to a Minor Under the Age 16	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 22 CFR 51.27

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DS-3053	Statement of Consent: Issuance of a U.S. Passport to a Minor Under the Age 16	DS-3053.pdf		Yes	No	Printable Only
Form and Instruction	DS-3053	Statement of Consent: Issuance of a U.S. Passport to a Minor Under the Age 16	DS-3053 (08-2013 rev).pdf		Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 556,075	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	556,075	-468,925	1,025,000
Annual IC Time Burden (Hours)	185,340	-839,660	1,025,000
Annual IC Cost Burden (Dollars)	1,390,188	-1,172,312	2,562,500

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.