DS-10, Birth Affidavit
Form DS-10 is a sworn statement used to help prove U.S. birth when an acceptable birth certificate does not exist. Fill in the official PDF below, then have it notarized and submit it with your passport application.
This is the genuine DOS PDF, unmodified. Source: DOS official page.
What is DS-10?
Form DS-10, Birth Affidavit, is a State Department form used as secondary evidence of birth in the United States for a passport application. It comes into play when the applicant cannot present an acceptable certified birth certificate, typically because the birth was never recorded or the state issued only a letter of no record.
The affidavit is not completed by the applicant. It must be sworn by someone with personal knowledge of the birth, preferably an older blood relative or the physician or other attendant present at the birth, who explains how they know the facts. It is submitted along with the letter of no record and early public or private records, such as baptismal certificates, hospital records, or census records, that support the claimed birth facts.
Who files DS-10?
- Passport applicants whose U.S. birth was never officially recorded
- Applicants whose state issued a letter of no record instead of a birth certificate
- Older blood relatives or birth attendants swearing to the facts of an applicant’s birth
- Applicants whose available birth record is otherwise not acceptable for passport purposes
How to fill out DS-10
- Fill in the applicant’s birth facts: full name, date of birth, and place of birth.
- Have the affiant, ideally an older blood relative or the attendant at the birth, complete their information and explain their personal knowledge of the birth.
- Leave the signature blank until the affiant is before a notary; the affidavit must be notarized.
- Gather the state’s letter of no record and early records supporting the birth facts.
- Download the PDF and submit the notarized affidavit with Form DS-11 and your supporting evidence at a passport acceptance facility or agency.
Quick fill DS-10 on this page
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Frequently asked questions
Who can sign a DS-10 birth affidavit?
Someone with personal knowledge of your birth, preferably an older blood relative such as a parent or an aunt or uncle, or the physician or attendant who was present. If no such person is available, check current guidance at travel.state.gov for what the State Department will accept.
Is the DS-10 enough on its own to prove citizenship?
No. It supports a birth claim together with a letter of no record from the state and early documentary evidence. The stronger and earlier the accompanying records, the better.
Does the form need to be notarized?
Yes. The affiant must sign before a notary public for the affidavit to be accepted.