Government of India
Ministry of External Affairs
CPV Division, Delhi

ANNEXURE C

AFFIDAVIT TO BE SUBMITTED WITH THE APPLICATION FOR A PASSPORT OF A MINOR CHILD BY EITHER PARENT (WHO ARE SEPARATED BUT NOT FORMALLY DIVORCED) OR BY A SINGLE PARENT OF THE CHILD BORN OUT OF WEDLOCK

(To be executed on non-judicial stamp paper) 

I, (name of single parent) solemnly declare and affirm as follows: 

1.                 That I am the mother/father of  (name of the child) who is a minor child and on  whose behalf I have made an application for his/her passport. 

2.       That I am judicially separated from the mother/father of  (name of minor). 

                                                                        OR

            That no legally valid marriage ever existed between me and Mr./Ms.(the father/mother the minor child) 

                                                                         OR

The father/mother of  (name of the child) has deserted me after conception/ delivery 

3.       That (name of the minor) is exclusively under my care and custody since separation/delivery.  

                 Signature & address of Deponent

  Date:

(Sworn before the First Class Judicial Magistrate or Notary Public)