Embassy of the United States Bamako, Mali

Submit form DS-3053 if:

• You are the non-applying parent or guardian providing written consent for your minor child to apply for a U.S. passport because you are unable to appear in person with your child (Statement of Consent) or
• You are the applying parent or guardian, and the written consent of the non-applying parent or guardian cannot be obtained (Statement of Special Circumstances)

STEP 1: Complete and Print Form

Complete Form DS-3053 (PDF) using black ink.  Make sure that all of the entered information is complete and correct. Illegible applications may delay application processing times.

• Complete item 4a, Statement of Consent, only if you are a non-applying parent or guardian consenting to the issuance of a passport for your minor child.
• Complete item 5, Statement of Special Circumstances, only if you are an applying parent or guardian and the written consent of the non-applying parent or guardian cannot be obtained. The statement must explain in detail the non-applying parent's unavailability and recent efforts made to contact the non-applying parent.

STEP 2: Notarize Form DS-3053 & Submit Photocopy of the ID (Only with Statement of Consent)

Step 2 only applies if you are submitting Form DS-3053 as a Statement of Consent.  Statements of Special Circumstances do not need to be notarized.  If you are a non-applying parent or guardian consenting to the issuance of a passport for a minor child, you must:

• Sign and date Form DS-3053 in the presence of a Certified Notary Public
• Submit a photocopy of the front and back side of your ID with Form DS-3053

STEP 3: Submit Form DS-3053 + Completed Form DS-11

In all cases, the original Form DS-3053 must be submitted to Consular Section at the U.S. Embassy Bamako.

IMPORTANT: A Statement of Consent from a non-applying parent must be submitted with the minor's passport application within 3 months of the date it was notarized.  A new, notarized Statement of Consent from the non-applying parent will be required for future applications.