Last Updated: February 9, 2023.
About this Form
This form is an authorization letter for foreign travel with a minor. It is meant to be used by parents or legal guardians of a minor child who is a citizen of the United States of America and is planning to travel outside of the country. The form provides information about the minor child, such as their name, date of birth, and passport number. It also provides information about the adult with whom the child will be traveling and the purpose of the trip.
The parents or guardians must sign the form in the presence of a notary public, attesting to their legal custody of the child and granting authorization for the child to travel. Additionally, the parents or guardians provide their contact information. The form serves as proof of authorization for the child to travel and may be required by airlines, foreign governments, or other organizations.
AUTHORIZATION FOR FOREIGN TRAVEL WITH MINOR
To Whom It May Concern:
This letter is in relation to my child,
_____________________________________________ [name of child] , who is a citizen of the United States of America and a minor born on
_________________________ [specify child’s date of birth] . My child holds a U.S. passport with the number
_________________________.
I do solemnly swear that I have legal custody of my child and that no pending divorce or child custody proceedings involving my child exist. I do hereby grant full authorization and consent for my child to travel outside of the United States with
_________________________ [specify name of adult with whom child will travel] , who is the
_________________________ [specify adult’s relationship with child] of my child. The purpose of the travel is
_________________________ [specify vacation, touring, to visit relatives, to accompany adult on business trip or other reason] . I have approved the following travel plans:
Dates of travel: Destinations/Accommodations:
_________________ _______________________________________________________ ______________________________________
I authorize
_____________________________________________ [name of adult with whom child will travel] to make any changes whatsoever to the travel plans specified above.
Under penalty of perjury under the laws of the state of ______________________, I attest to the truthfulness, accuracy, and validity of the forgoing statement.
____________________________________ ___________________Parent 1's Signature Date
____________________________________ ___________________Parent 2's Signature Date
Parent #1: Name:
________________________________________________________________________Address:
______________________________________________________________________Home phone:
__________________________ Work phone:
__________________________Cell phone:
____________________________ Pager:
_______________________________Email:
________________________________Additional Contact Information:
____________________________________________________________________________________________________________________________________
Parent #2: Name:
________________________________________________________________________Address:
______________________________________________________________________Home phone:
__________________________ Work phone:
__________________________Cell phone:
____________________________ Pager:
_______________________________Email:
________________________________Additional Contact Information:
____________________________________________________________________________________________________________________________________
CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC
STATE OF
__________________COUNTY OF
________________
Acknowledged before me on
___________________ [date] by
__________________________________ [name of principal].
[Notary Seal, if any]:
_______________________________(Signature of Notarial Officer)
Notary Public for the State of
__________________
My commission expires:
______________________
