DS-10 Birth Affidavit Passport Form

Form DS-10-full page small
All applications for a U.S. passport must include appropriate proof of citizenship when applying for a passport.

The standard form of proof is either your birth certificate or paperwork documenting naturalization. If you have lost or do not have a birth certificate, you must follow the steps provided for a Missing Birth Certificate called Birth Affidavit.

Purpose of the DS-10 Birth Affidavit Passport Form

The necessary DS-10 Birth Affidavit Passport Form can be downloaded online. This birth affidavit is provided for use by an applicant when an acceptable birth certificate is not available for a person born in the United States. When submitted, the form must include a written statement by the relevant authority that no birth certificate or record exists. Additionally, the applicant must provide a photocopy of both the front and back side of their identification.

Applicants may also submit a birth affidavit along with other records of birth. Any applicant submitting a birth affidavit must have personal knowledge concerning the facts related to the birth of the applicant who is seeking to prove their birth in the United States.

The details to be included in the affidavit should include a brief statement as to how the applicant acquired the knowledge of the birth. The affidavit submitted should preferably be by a blood relative older than the applicant. However, it is permissible to have the affidavit be prepared by the physician attending the birth or another person with personal knowledge of the applicant’s birth.

Passport Services will retain all completed affidavits and any copies needed by the applicant should be requested at the time the affidavits are completed

The Birth Affidavit for Passport DS-10

Proof of U.S. citizenship is possible by use of a DS-10 Birth Affidavit Passport Form. This form is viewed as a secondary type of confirmation of United States citizenship. When submitted with other appropriate early public records, you can submit this form to help confirm your citizenship. However, this form is to be used only when the standard long form birth certificate is not available.

Submitting the Passport Form DS-10

You or the applicant for a passport do not fill out or complete the DS-10 Birth Affidavit Passport Form. You submit it along with all other required documents to the acceptance agent. There is an Instructional Checklist that provides additional information on the specific documents and steps involved with the passport type you are seeking. The submitted affidavit is completed by an individual, preferably an older blood relative, with personal knowledge about the birth of the applicant and must be notarized. Other requirements for this form include:

Confirmation that no other birth record exists

Accompanied by a photocopy of the ID, front and back, of the person submitting the affidavit
The DS-10 Birth Affidavit Passport Form itself is not sufficient evidence of U.S. citizenship. It must be submitted along with such early public records as Census records, family Bible records, doctor’s records, and/or Baptismal certificates and hospital birth certificates.

Parts of the DS-10

The top part of the form DS-10 contains individual information. Fill out all sections. If any item is not applicable fill in n/a.

Form DS-10 To Section Information

The middle section of the form DS-10 is filled out by your reference (someone who knows you).

Form DS-10-middle section-reference info

The bottom section is the affidavit section where you sign and have notarized the form. Be sure to sign it in front of the notary who must apply his stamp of notarization to the form.

Form DS-10-bottom section-afidavit info