Download and use this when you need an Authorization for Travelling to a foreign country with a Minor.
Authorization for Foreign Travel With Minor
Text Version of this Form
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Authorization for Foreign Travel With Minor
To Whom It May Concern:
This letter concerns my child, __________________________________ [name of child],
a United States citizen and a minor born on _________________________ [child’s date
of birth], who carries a United States passport with the number ____________________.
I affirm that I have legal custody of my child, and that there are no pending divorce or
child custody proceedings that involve my child. I give my full authorization and consent
for my child to travel outside of the United States with ___________________________
[name of adult with whom child will travel], who is the _______________ [state 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:
____________________ ____________________________________________
____________________ ____________________________________________
Furthermore, I hereby authorize ____________________ [name of adult with whom
child will travel] to modify the travel plans specified above as he/she deems necessary.
I declare under penalty of perjury under the laws of the state of ____________________
that the foregoing is true and correct.
Parent 1’s signature: _____________________________________________________
Date: ____________________
© 2007 Nolo Authorization for Foreign Travel With Minor Page 1
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Printed name: ________________________________
Address: ______________________
______________________
Home phone: ____________________ Work phone: ____________________
Cell phone or pager: ____________________ Email: ____________________
Parent 2’s signature: _____________________________________________________
Date: ____________________
Printed name: ________________________________
Address: ______________________
______________________
Home phone: ____________________ Work phone: ____________________
Cell phone or pager: ____________________ Email: ____________________
Certificate of Acknowledgment of Notary Public
State of _______________________________ )
) ss
County of _____________________________ )
On _____________________, before me, ______________________________, a notary
public in and for said state, personally appeared ___________________
________________________, personally known to me (or proved to me on the basis of
satisfactory evidence) to be the person whose name is subscribed to the within
instrument, and acknowledged to me that he or she executed the same in his or her
authorized capacity and that by his or her signature on the instrument, the person, or the
entity upon behalf of which the person acted, executed the instrument.WITNESS my hand and official seal.
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_____________________________________
Notary Public for the State of ______________
My commission expires __________________
[NOTARY SEAL]
© 2007 Nolo Authorization for Foreign Travel With Minor Page 3