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Form DS-5525 PDF Template

What is a Form DS-5525?

Form DS-5525, the "Statement of Exigent/Special Family Circumstances for Issuance of a U.S. Passport to a Child Under Age 16," is utilized when applying for a U.S. passport for a child below 16 years old. In situations where obtaining the signature of both parents or legal guardians is not feasible, this form provides a means to explain why and to request an exception. It's specifically designed to address cases where a parent or legal guardian with custody cannot provide consent due to exigent or special family circumstances.


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How to Fill in Our Form DS-5525 PDF Template

Follow these steps to fill in the Form DS-5525 template:

  • Child’s Information:

    • Enter the child's full name (last, first, middle) and date of birth in the respective fields.

  • Applying Parent/Legal Guardian’s Information:

    • Provide the applying parent or legal guardian's full name (last, first, middle).

  • Non-Applying Parent/Legal Guardian’s Information:

    • Fill out fields a - e with details about the non-applying parent/legal guardian, including name, date of birth, other names used, contact information (telephone, email, address).

  • Court Orders:

    • Indicate if any court orders related to custody or travel of the child exist. If yes, submit certified copies with the form.

  • Incarceration Status:

    • Specify if the non-applying parent/legal guardian is currently incarcerated. If yes, provide evidence of incarceration.

  • Communication Attempts:

    • Describe when and how communication was attempted with the non-applying parent/legal guardian. Include details of attempts made via mail, phone, email, social media, or other means. If contacting through a relative or friend, provide their details.

  • Explanation of Consent Issues:

    • In detail, explain attempts to obtain consent from the non-applying parent/legal guardian and why it hasn't been possible. Use information provided in previous questions to support your statement.

  • Oath:

    • The applying parent or legal guardian must sign and date the form, declaring under penalty of perjury that all statements made are true and correct.

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