Official Federal Forms > US Department Of State > Passport
Request For Entry Into Childrens Passport Issuance Alert Program DS-3077 - Official Federal Forms
| Request For Entry Into Childrens Passport Issuance Alert Program Form. This is a national form and can be used in Passport US Department Of State . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
U.S. Department of State *OMB APPROVAL NO. 1405-0169 EXPIRATION DATE: 1/31/2016 ESTIMATED BURDEN: 30 Minutes* REQUEST FOR ENTRY INTO CHILDREN'S PASSPORT ISSUANCE ALERT PROGRAM REQUEST FORM An alert request may be filed with respect to an unmarried child under the age of 18. This request can be filed by concerned parents of U.S. citizen children, their appointed agents, or other persons having legal custody of the child. Complete one form for each child, and submit the completed request along with proper documents to Passport Services by e-mail, fax or mail. By signing this form you are affirming that your parental rights to this child have not been terminated by court order. 1. Please provide information about the child in order to make the alert system effective. Please print clearly or type the information. Date of Birth (mm-dd-yyyy) Place of Birth Child's Full Name (Last, First, Middle) Child's Sex Female Male Social Security Number U.S. Passport Number(s) , if any 2. Please provide the following information about yourself so that we can acknowledge your request, and alert you in the future. Documentation of Identity Provided Other Form of Photo Driver's License Identification with Signature Passport Your Full Name (Last, First, Middle) Relationship to Child Shown Above Documentation of Parentage, Guardianship, Legal Custody OR Authority to Act on Behalf of Parent or Legal Guardian, as applicable Birth Certificate Current Custody/ Guardianship Court Order(s) Consular Report of Birth Abroad (CRBA) Evidence of Authority to Act on Behalf of Parent or Legal Custodian City Adoption Decree Other State or Country Postal Code Mailing Address NOTE: Since the Department will need to contact you, it is very important that you keep us informed in writing or by telephone of any changes to your contact information. Failure to notify this office of your correct address and phone number may result in passport issuance for your child without your knowledge. Home Phone Work Phone Cell Phone Email Address(es) 3. I request that the U.S. Department of State notify me if it receives a U.S. passport application for the above-mentioned child, or if an application is currently pending, or if there is any U.S. passport still valid for the child's travel. I object to the Issuance of a U.S. Passport to the Aforementioned Child, but I understand that under prescribed circumstances (see 22 CFR 51.28) the Department is authorized to issue the passport nonetheless. Signature Date (mm-dd-yyyy) Please read the Dual Nationality for Children information accompanying this form. It relates to a child who may have a foreign nationality in addition to U.S. nationality. Please submit via e-mail, fax, or mail the completed form along with the proper copies of the original documents to the U.S. Department of State, Overseas Citizen Services, Children's Issues; Attention: Children's Passport Issuance Alert Program; 2201 C Street NW, SA-29, Washington, DC 20520; Email: PreventAbduction@state.gov; Telephone Number 1-888-407-4747, Fax Number 202-736-9133. DS-3077 01-2013 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com DUAL NATIONALITY FOR CHILDREN Many children, born in the U.S. or born abroad to a U.S. citizen parent, are citizens of both the U.S. and another country. A child may acquire the citizenship of a foreign country, for example, through the child's birth abroad, or through a parent. There is no requirement that a U.S. citizen parent consent to a child's acquisition of another nationality. Even though U.S. law may prevent one parent from obtaining a U.S. passport for a child (for example, because of the two-parent signature requirement), a parent may still be able to obtain a foreign passport for a dual national child from the embassy or government of the other country. Under U.S. law, a United States citizen child is required to enter and depart the United States on his or her United States passport. However, please be advised that, since there are currently no exit controls from the United States, U.S. citizen children can still exit the United States undetected on foreign passports. U.S. law and regulations concerning the issuance of U.S. passports do not apply to foreign governments when they issue passports to people (including children) whom they consider to be citizens of their country, whether or not the foreign passport is issued in the United States and/or to a person the United States considers to be a U.S. citizen. If you think there is a possibility that your child may have another nationality, you are encouraged to contact the relevant country's embassy or consulate directly to inquire about the rules governing the issuance of that country's passport to your child, including the possible availability of mechanisms to prevent the issuance to your child of that country's passport without your consent. The address and telephone numbers for the embassies and consulates for foreign countries within the United States can be found on the Consular Affairs web page at >>travel.state.gov<< under each foreign country's Country Specific Information. PRIVACY ACT STATEMENT AUTHORITY: The information solicited on this form is requested pursuant to provisions in Titles 8 and 22 of the U.S. Code, as well as the corresponding federal regulations, including specifically 22 U.S.C. § 211a and Public Law 106-113, Div. B, §1000(a)(7) [Div. A., Title II, §236] of the Admiral James W. Nance and Meg Donovan Foreign Relations Authorization Act, Fiscal Years 2000 and 2001 and Executive Order 11295 (Aug. 5, 1966), and the regulations contained in 22 C.F.R. § 51.28. PURPOSE: The primary purpose for soliciting the information is to enable the U.S. Department of State to notify you of any pending U.S. passport applications for the child identified on the form and of any U.S. passport held by the child that is still valid for travel. The child's social security number is requested because that number is a unique identifier used to establish the identity of the passport holder. ROUTINE USES: The information solicited on this form may be made available as a routine use to other government agencies, to assist the U.S. Department of State in adjudicating passport applications and requests for related services, and for law enforcement and administrative purposes. It may also be disclosed pursuant to court order. The information may be made available to foreign government agencies to fulfill passport control and immigration d
|
|||||||
