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

ICR 201607-1405-003

OMB: 1405-0129

Federal Form Document

Forms and Documents
Form and Instruction
Supplementary Document
Supporting Statement A
ICR Details
1405-0129 201607-1405-003
Historical Active 201306-1405-002
Statement of Consent: Issuance of a U.S. Passport to a Minor Under the Age 16
Revision of a currently approved collection   No
Approved with change 08/23/2016
Retrieve Notice of Action (NOA) 07/08/2016
  Inventory as of this Action Requested Previously Approved
08/31/2019 36 Months From Approved 08/31/2016
465,848 0 556,075
155,127 0 185,340
1,164,620 0 1,390,188

The information collected on the DS-3053 is used to facilitate the issuance of passports to U.S. citizens and nationals under the age of 16. The primary purpose of soliciting the information is to ensure that both parents and/or all guardians consent to the issuance of a passport to a minor under the age 16, except where one parent has sole custody or there are exigent or special family circumstances.

PL: Pub.L. 106 - 113 Section 1000 (a)(7)), Name of Law: Foreign Relations Authorization Act, Fiscal Year 2000 and 2001
   US Code: 22 USC 211a Name of Law: Authority to grant, issue, and verify passports
   US Code: 8 USC 1104 Name of Law: Powers and duties of Secretary of State
   US Code: 18 USC 1542-1544 Name of Law: False statement in application and use of passport
   US Code: 22 USC 6039E Name of Law: Information concerning resident status

Not associated with rulemaking

  81 FR 17754 03/30/2016
81 FR 43693 07/05/2016

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 465,848 556,075 0 -90,227 0 0
Annual Time Burden (Hours) 155,127 185,340 0 -30,213 0 0
Annual Cost Burden (Dollars) 1,164,620 1,390,188 0 -225,568 0 0
Changing Forms
15. Demand forecast projections, by their nature, will have some uncertainty in their accuracy, which can explain differences between actual and forecast. However, the decrease from the previous burden estimates (556,075 respondents to 465,848 and $1,390,188 in cost burden to respondents to $1,164,620) may be attributed to splitting the one form into two. The DS-5525, Statement of Exigent/Special Family Circumstances for Issuance of a U.S. Passport to a Minor under Age 16, was introduced in the last three year cycle and the Department is still adjusting its impact on forecasts and workload.

Alexys Garcia 202 736-9216 [email protected]


On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

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