Government of India
Ministry of External Affairs
CPV Division, Delhi

ANNEXURE H

DECLARATION OF APPLICANT PARENT OR GUARDIAN IF PASSPORT IS FOR MINOR: ON PLAIN PAPER

                              I/We affirm that the particulars given above are in respect of (name of the child) son/daughter of Shri. and  Shrimati of whom I/we am/are the Parents/Single Parents/Applicant Parent/Guardians. He/She is a Citizen of India. His/Her date of birth/place of Birth is ----------. I/We undertake the entire responsibility for his/her expenses.  I/We solemnly declare that he/she has not lost, surrendered or been deprived of his/her citizenship of India and that the information given in respect of him/her in this application is true.  It is also certified that I/we am/are holding/not holding valid Indian passport(s) and the name of the child mentioned is not included in Passport of either parent.                 

_____________          /                 _________________            OR___________________

Father (Signature)                       Mother (Signature)             Legal Guardian (Signature)

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