The department of state has a blank pdf copy of this document, which you can download, print and fill out. It should only be used when the standard birth certificate is unavailable. Fsm passport affidavit form embassy of the federated. To create the affidavit, you must find a person with personal. If your birth certificate has been proven unavailable or insufficient, then there are two things that the government agency may request for. Page 4 of 4 revised april 2018 proof of parental consent if one or both parents listed on the birth certificate is not present parentslegal guardians not present for the interview must provide an original statement of onsent form ds3053 authorizing the issuance of a u. Department of state purpose a birth affidavit should be submitted with an application for a u. Census record early school records doctors records of postnatal care baptism certificate family bible record form. Dos 60day notice and request for comments on proposed revisions to form ds 10, birth affidavit, which is used to show u. Birth affidavit in order to apply for a new passport. Department of state of the views or products contained therein. This form is viewed as a secondary type of confirmation of united states citizenship. Department of state birth affidavit omb expiration date. A birth affidavit must be made by a person who has personal knowledge of the facts.
It is very similar to affidavit of service forms wherein it is used as a form of confirmation, in this case it is used to see a persons actual date of birth. Department of state purpose a birth affidavit may be submitted with an application for a u. Use fill to complete blank online others pdf forms. When submitted with other appropriate early public records, you can submit this form to help confirm your citizenship. The birth affidavit should be made by a person who has knowledge of the date and place of birth of the person whose birth in the united states is to be proved. Purpose a birth affidavit may be submitted with an application for a u. A birth affidavit must be made by an individual who has personal knowledge of the facts of the birth of the applicant whose birth in the united states is to be proved.
A birth affidavit ds10 pdf 192 kb, completed by an older blood relative who has personal knowledge of your birth. Department of state birth affidavit omb expiration. Application for birth affidavit page 3 requirements birth affidavit. That the enclosed date of birth proof is true and genuine and i shall be fully responsible for submitting any fake document. Notarized letter form both parents certifying that you were born in liberia or to liberian parents 2. Ds2029 application for consular report of birth abroad. Department of state home office of directives contact us. Insurance files or published birth announcements such as a newspaper article. Ds3053, statement of consent or special circumstances issuance of a. Sign, fax and printable from pc, ipad, tablet or mobile.
Fsm passport affidavit form embassy of the federated states. Brian was adopted into his family when he was just two years old. Name of child in full application for consular report of birth abroad of a citizen of the united states of america u. What are the requirements for a passport nationwide. A form ds10 is considered a secondary type of citizenship confirmation. Edit, fill, sign, download birth affidavit form online on. These documents are made in the event that a person has an incomplete birth record, is unable to. The birth affidavit should be made by a person who has knowledge of the date and place of birth of the person whose birth in th e united states is to be proved. Purpose a birth affidavit should be submitted with an application for a u. Download free printonly pdf or purchase interactive pdf version of this form. Ds 10, birth affidavit, omb control number 140502 a notice by the state department on 08042004 document details. A ds 10 birth affidavit passport form should be submitted with all other required documents to an acceptance agent. Other supporting documentation of your birth, which may include.
The birth affidavit would usually come from individuals who were alive at the time of your birth, or. Notarized affidavits or ds10, birth affidavit of older blood relatives having knowledge of your birth may be submitted in addition to some of the records listed. If there is no record of your birth, you may submit a birth affidavit or form ds 10 in addition to early public records and other required documentation set forth by the government. Dos 60day notice and request for comments on proposed revisions to form ds10, birth affidavit, which is used to show u. If you are unable to obtain an acceptable birth certificate, you may submit an affidavit of birth as a substitute.
Remember that this form is a standardized form and different from affidavit of support forms. The affidavit must be accompanied by a notice from the appropriate authorities indicating that no birth record exists and a photocopy of the front and back side of the affiants identification. Ds2029 application for consular report of birth abroad eda. If there is no record of your birth, you may submit a birth affidavit or form ds10 in addition to early public records and other required documentation set forth by the government. When you fill out this form, be sure to write clearly and. Form ds 10 should not be completed by the applicant. Ds 10 birth affidavit passport form applying for a passport requires an application and supporting documents. Passport renewal application for eligible individuals. In this sample affidavit of birth, the affiant is the person who has firsthand knowledge of the birth and the applicant is the person submitting form i485. Fill free fillable form ds10 wilkinson birth affidavit 2001 pdf. Use fill to complete blank online others pdf forms for free. Census record early school records doctors records of postnatal care baptism certificate family bible.
The purpose of passport document ds 10 is to allow you to submit a birth affidavit, along with your application for a us passport, when an acceptable birth certificate cannot be obtained for a person born in the united states. Online solutions allow you to to arrange your document administration and improve the. Secondary must submit more than one born in the united. Notarized affidavits or ds10, birth affidavit of older blood relatives having knowledge of your birth may be submitted in addition to some of the records listed above.
Name of applicant whose birth in the united states is to be proved 2. Sample affidavit of birth for form i485 citizenpath. Your relationship to the applicant or the basis of your knowledge regarding the applicant birth affidavit apartment number. Aila dos 60day notice and request for comments on proposed. Ds10 birth affidavit passport form birth affidavit to. This is a official federal forms form and can be use in passport us department of state. Fill online, printable, fillable, blank form ds10 birth affidavit form. Fill free fillable form ds10 wilkinson birth affidavit. The birth affidavit form may also be submitted in conjunction with other birth records. The office of website management, bureau of public affairs, manages this site as a portal for information from the u. Application to determine returning resident status. External links to other internet sites should not be construed as an endorsement of the views or privacy policies contained therein.
Fill online, printable, fillable, blank form ds10 wilkinson birth affidavit 2001 form. A birth of affidavit is something made in the event that the person is required to provide proof or birth. Ds10 birth affidavit passport form applying for a passport requires an application and supporting documents. Notarized affidavits or ds 10, birth affidavit of older blood relatives having knowledge of your birth may be submitted in addition to some of the records listed above. Applicants date of birth purpose a birth affidavit should be submitted with an application for a u. Form ds10, birth affidavit o should be completed by an older blood relative or attending physician. Checklist for a consular report of birth abroad crba. View, download and print ds10 birth affidavit us department of state pdf template or form online. Use the pdf linked in the document sidebar for the official electronic format. Links to external websites are provided as a convenience and should not be construed as an endorsement by the u. The supporting documents will help provide personal information like proof of citizenship. This affidavit of birth can be used to verify under oath the facts surrounding an individuals birth. Fill online, printable, fillable, blank form ds 10 birth affidavit form.
A blank copy of the ds 10 affidavit for birth certificate is available on the federal governments website. Although he was born in california over two decades ago, his birth records were sealed when his adoption was finalized. It must also be submitted with other appropriate early public records. A birth affidavit must be a birth affidavit must be made by an individual who has personal know l edge of the facts of the applic ants birth in the united st ates. View, download and print ds 10 birth affidavit us department of state pdf template or form online. A birth affidavit may also be submit ted in conjunction with other birth records. That i do not have any other date of birth proof i. The department of state has submitted the following information collection request to the office of management and budget omb for approval in accordance with the paperwork reduction act of 1995. A ds10 birth affidavit passport form should be submitted with all other required documents to an acceptance agent. Jan 18, 2019 the birth affidavit for passport ds 10. These documents are a birth certificate, naturalization certificate or an expired passport. A form ds 10 is considered a secondary type of citizenship confirmation. Fill free fillable form ds10 birth affidavit pdf form.
A birth affidavit may also be submitted in conjunction with other birth records. Fill free fillable form ds10 wilkinson birth affidavit 2001. A consular report of birth abroad may be issued for any u. Ds10 form 2017 2019 printable and fillable, blank pdf. Ds10 birth affidavit passport form birth affidavit to get a passport. Once completed you can sign your fillable form or send for signing. Ds10 birth affidavit passport form birth affidavit to get. Ds10 omb approved exp 731202 department of state form.
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