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AS DIRECTED BY PUBLIC LAW 106-113 AND 22 CFR 51.28: To submit an application for a child under age 16 both parents or the child's legal guardian(s) must appear and present the following: - Evidence of the child's U.S. citizenship; - Evidence of the child's relationship to parents/guardian(s); AND - Original parental/guardian government-issued identification AND a photocopy of the front and back side of presented identification. IF ONLY ONE PARENT APPEARS, YOU MUST ALSO SUBMIT ONE OF THE FOLLOWING: - Second parent's notarized written statement or DS-3053 (including the child's full name and date of birth) consenting to the passport issuance for the child. The notarized statement cannot be more than three months old and must be signed and notarized on the same day, and must come with a photocopy of the front and back side of the second parent's government-issued photo identification; OR - Second parent’s death certificate if second parent is deceased; OR - Primary evidence of sole authority to apply, such as a court order; OR - A written statement or DS-5525 (made under penalty of perjury) explaining in detail the second parent's unavailability.  AS DIRECTED BY REGULATION 22 C.F.R. 51.21 AND 51.28: - Each minor child applying for a U.S. passport book and/or passport card must appear in person. REQUIREMENTS FOR CHILDREN FAILURE TO PROVIDE INFORMATION REQUESTED ON THIS FORM, INCLUDING YOUR SOCIAL SECURITY NUMBER, MAY RESULT IN SIGNIFICANT PROCESSING DELAYS AND/OR THE DENIAL OF YOUR APPLICATION. FOR INFORMATION AND QUESTIONS Visit the official Department of State website at travel.state.gov or contact the National Passport Information Center (NPIC) via toll-free at 1-877-487-2778 (TDD: 1-888-874-7793) and NPIC@state.gov. Customer Service Representatives are available Monday-Friday 8:00a.m.-10:00p.m. Eastern Time (excluding federal holidays). Automated information is available 24 hours a day, 7 days a week. U Table of Contents Home A. Program Description A1. What is this grant program? A2. What are indicators of successful projects? A3. What are the IMLS agency-level goals? A4. What is of special interest to IMLS for FY18? A5. What are the project categories? A6. Where can I find the authorizing statute and regulations for this funding opportunity? B. Federal Award Information C. Eligibility Information C1. What are the eligibility requirements for this program? C2. What are the cost sharing requirements for this program? C3. Other information D. Application and Submission Information D1. How can we find the application package? D2. What content and form are required to make a complete application? D3. What are the registration requirements for submitting an application? D4. When and how must we submit our application? D5. Is there an intergovernmental review? D6. Are there funding restrictions? E. Application Review Information F. Award Administration Information G. Contacts H. Other Information I. Appendices Name: Signature & Official Stamp: Date of: D D M M Y Y Y Y Postal Address: P.O. Box: Town/City: Postal Code: Tel/Mobile Number: 2. Provincial Administration (Chief or Asst. Chief). How long have you known the candidate/family? ______________________________________________________________________ Rate the candidates financial ability: Very Rich Rich Middle Income Poor Very Poor Yes No Orphaned Parents/Guardians are employed Parents/Guardians Any additional information, explain: I have reviewed the information given in this form and believe it to be truthful. The above named student is a resident of my location/ sub-location. Based on my knowledge and/or inquiries, I affirm that he is needy/vulnerable. Name: Signature & Official Stamp: Date of: D D M M Y Y Y Y Postal Address: P.O. Box: Town/City: Postal Code: Tel/Mobile Number: 3. Religious Leader (bishop, pastor, priest, imam, etc.) How long have you known the candidate/family? ______________________________________________________________________ Rate the candidate’s financial ability: Very Rich Rich Middle Income Poor Very Needy I have reviewed the information given in this form and believe it to be truthful. Based on my knowledge and/or inquiries I affirm that this student is needy/vulnerable based on the following facts about his/her circumstances.

posted by Isaac Hobart at 11:56 AM

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