This form is used when no birth certificate exists for a person born in the United States or when a U.S. birth certificate was filed more than a year after birth. This form, or a written statement that includes all of the information on this form, must be filled out by a close blood relative (for example, an older brother or sister) who has personal knowledge of the details of the passport applicant’s birth or by a person who was personally involved in the passport applicant’s birth (for example, the attending physician).
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