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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:
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.
CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC
STATE OF __________________
Acknowledged before me on ___________________ [date] by __________________________________ [name of principal].
[Notary Seal, if any]:
Notary Public for the State of
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