Form Ds 3077 PDF Details

Recognizing the challenges and concerns surrounding the international travel of minors, the U.S. Department of State has established the Children's Passport Issuance Alert Program, facilitated through the DS-3077 form. This form serves as a request tool for parents, legal guardians, or individuals with authorized custody to be alerted in the event of a U.S. passport application submission for minors under the age of 18. The comprehensive nature of this request form requires detailed information about the child and the applicant, ensuring the system's effectiveness in preventing potential international child abductions and making certain that legal custodians are aware of passport applications pertaining to their children. Critical to its operation, the form emphasizes the significance of accompanying documentation proving the requester's legal authority over the child. Such a precaution underscores the U.S. Department of State's commitment to safeguarding children's travel and maintaining the informed consent of legal guardians regarding passport issuance, all the while acknowledging scenarios involving dual nationality and providing guidance on preventing unintended passport issuances. Submitting this form is a proactive step towards securing a child's international travel oversight, backed by the legal and administrative framework designed to support concerned parents and guardians.

QuestionAnswer
Form NameForm Ds 3077
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namessorn, preventabduction1state, c25533, htm

Form Preview Example

U.S. Department of State

REQUEST FOR ENTRY INTO

CHILDREN'S PASSPORT ISSUANCE ALERT PROGRAM

*OMB CONTROL NO. 1405-0169 EXPIRATION DATE: 02-28-2021 ESTIMATED BURDEN: 30 Minutes*

REQUEST FORM An alert request may be filed with respect to a minor 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 the Office of Children's Issues by e-mail, fax, or mail. By signing this form you are affirming that you have parental rights to this child.

1.Please provide information about the child in order to make the alert system effective. Please print clearly or type the information.

Child's Full Name (Last, First, Middle)

Date of Birth (mm-dd-yyyy)

Place of Birth

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.

Your Full Name (Last, First, Middle)

Date of Birth (mm-dd-yyyy)

Place of Birth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Your Relationship to

Documentation of Parentage, Guardianship, Legal Custody OR Authority to Act on Behalf of Parent or Legal Guardian, as

 

Child Shown Above

applicable. Without this documentation, a child may not be enrolled in the Children's Passport Issuance Alert Program.

 

 

 

 

 

 

 

Birth Certificate

 

Consular Report of Birth Abroad (CRBA)

 

 

Adoption Decree

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Current Custody/

 

Evidence of Authority to Act on

 

 

Other

 

 

 

 

 

 

 

 

 

Guardianship Court

 

 

 

 

 

 

 

 

 

 

 

 

 

Behalf of Parent or Legal Custodian

 

 

 

 

 

 

 

 

 

 

 

Order(s)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Documentation of Identity Provided

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Driver's License

 

 

 

 

Passport

 

 

 

 

 

Other Form of Photo Identification with Signature

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

State or Country

Postal Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOTE: Since the Department may 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,

e-mail, 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 see additional information on preventing abductions at our website, childabduction.state.gov.

Please submit via e-mail, fax, or mail the completed form along with copies of the original documents to the U.S. Department of State, Overseas Citizen Services, Office of Children's Issues; Attention: Children's Passport Issuance Alert Program; SA-17, 9th Floor, Washington, DC 20522-1707; Email: PreventAbduction1@state.gov; Telephone Number 1-888-407-4747, Fax Number 202-485-6222.

DS-3077

Page 1 of 2

11-2018

 

DUAL NATIONALITY FOR CHILDREN

Many children, born in the United States or born abroad to a U.S. citizen parent, are citizens of both the United States 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. Many countries do not require the consent of all parents in order to acquire nationality and/or a passport. Therefore, even though U.S. law may prevent one parent from obtaining a U.S. passport for a child in the absence of two-parent consent, 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 U.S. citizen child is required to enter and depart the United States on his or her U.S. passport. However, please be advised that U.S. citizen children may still be able to depart the United States undetected on foreign passports.

U.S. laws and regulations concerning the issuance of U.S. passports do not apply to foreign governments issuing passports to people (including children) considered citizens of that 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 of foreign countries within the United States can be found on the Bureau of Consular Affairs web page at travel.state.gov.

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 duties. The information may also be provided to foreign government agencies, international organizations and, in limited cases, private persons and organizations to investigate, prosecute, or otherwise address potential violations of law or to further the Secretary's responsibility for the protection of U.S. nationals abroad. This would include, among other entities and agencies, disclosure to The National Center for Missing and Exploited Children, Central Authorities of countries party to the Hague Convention on the Civil Aspects of International Child Abduction ("the Convention"), attorneys of record and legal aid services to assist in facilitating operations under the Convention; local police in connection with notification of next-of-kin and child custody disputes; social services agencies; and parents involved in cases brought under the Convention. The information may also be made available to private U.S. citizen 'wardens' designated by U.S. embassies and consulates. For a more detailed listing of the routine uses to which this information may be put, see the Prefatory Statement of Routine Uses and the listing of routine user set forth in the System of Records Notice (SORN) for Overseas Citizens Services Records (State-05)., found at: http://www.state.gov/m/a/ips/c25533.htm

DISCLOSURE: Filing a request through the Children's Passport Issuance Alert Program and providing the information requested on this form, including the child's social security number, is voluntary. Failure to complete the form may result in a passport being issued to your child without your knowledge.

PAPERWORK REDUCTION ACT STATEMENT

Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time required for searching existing data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection. You do not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments on the accuracy of this burden estimate and/or recommendations for reducing it, please send them to: U.S. DEPARTMENT OF STATE, CA/OCS/L, 10th Floor, WASHINGTON, DC 20522-1707.

DS-3077

Page 2 of 2

How to Edit Form Ds 3077 Online for Free

It is possible to complete 2013 effectively using our online PDF editor. FormsPal is aimed at making sure you have the absolute best experience with our editor by continuously releasing new functions and enhancements. With all of these improvements, using our editor becomes better than ever! All it takes is several easy steps:

Step 1: Click the orange "Get Form" button above. It's going to open our editor so that you can start completing your form.

Step 2: The editor provides the capability to customize almost all PDF forms in various ways. Transform it by writing any text, correct what is originally in the PDF, and put in a signature - all when it's needed!

Filling out this form requires focus on details. Ensure that all necessary areas are done properly.

1. It's important to complete the 2013 accurately, therefore be mindful when working with the parts containing all these blanks:

Stage no. 1 in filling out yyyy

2. Now that the previous segment is complete, you need to put in the required details in Home Phone, Work Phone, Cell Phone, Email Addresses, I request that the US Department, I object to the Issuance of a US, see CFR, Signature, Date, mmddyyyy, Please read the dual nationality, Please submit via email fax or, and Page of so you can proceed to the third step.

I object to the Issuance of a US, Signature, and Email Addresses in yyyy

People frequently make mistakes when filling in I object to the Issuance of a US in this section. Be sure to read again what you type in right here.

Step 3: Spell-check the details you've inserted in the form fields and then press the "Done" button. Sign up with us today and instantly access 2013, set for download. Each edit you make is conveniently preserved , which means you can edit the form later when necessary. FormsPal guarantees your data privacy with a protected system that never records or distributes any kind of private data involved in the process. Be confident knowing your paperwork are kept safe any time you use our services!