ANNEXURE '0'
ecLARATION BY APPLICANTS PARENT(S) OR GUARDIAN FOR ISSUE OF
SPECIMEN D PASSPORT TO MINOR
(On plain paper)
resident of _ _ _ __
':8-==::::::::.=~:.~.~.::~·~·.·.::~.::.:.·.·::.:·.·::.............--...- ,.............••........................~~::~:.............. hereby affirm that the
rticUlars giVen below are of ........................_ ... _._............- ........._........ •..
:me of the child). son/daughter ol Shri ... _ ......-;...- ......................~;::;;;,..I/we am/are the parents /guard~::..
Sml _______..___............ _ ....... _ _ _ _ ...............
1. particyl3,s of minor child
Name:
Dateofbltth:
Place of bir1h :
2. The minor child mentioned above is a citizen of India.
3. I/We undertake the entire responsibility for his/her expenses.
4. I/We solOIMly dedare that he /she has not los~ surrendered o, been deprived of his/her citizenship of
India and that the information given in respect of himlller in this application Js true.
5. It 1s also certified that I/we am/are hok:ting /not holding valid India passporl{s).
Place: Date:
Signature of father Signature or mother
Passpot1No.: ....................................... .... or Passport No.: ...................................... .... or
Aadhaar C8n:t No.: ..................................... or Aacllaar Card No....................................... . o,
Voter ID Card No.:....................................... Voter ID Card No.: ......................................
Signature of legal guardiari{s)
Passport No.: ....................................... ...... 01'
Aadhaar CardNo.: ...................................... °'
Voter ID Card No.: ............................ , ..........
