SPECIMEN FORM OF AFFIDAVIT TO BE SUBMITTED BY THE PARENT(S) STAYING

ABROAD, DULY ATTESTED BY THE INDIAN MISSION CONCERNED, IN RESPECT OF THE

CHILD FOR WHOM AN APPLICATION IS BEING SUBMITTED TO PASSPORT OFFICES BY
THE OTHER PARENT FOR ISSUE OF PASSPORT.

I_____________________________________________________________________________ SON OF
____________________________________________________ RESIDING AT USA________________
_____________________________________________________________________________________,
DO HEREBY DECLARE THAT I AM HOLDING PASSPORT NO. ______________________, ISSUED
ON (dd/mm/yy) _______/________/__________, VALID UPTO __________/__________/__________,
ISSUED AT ___________________________, I UNDERSTAND THAT MY WIFE / HUSBAND IS
APPLYING FOR ISSUE OF PASSPORT FOR MY SON/DAUGHTER ___________________________.
I FURTHER DECLARE THAT THE PARTICULARS OF THE SAID CHILD ARE NOT INCLUDED IN
MY PASSPORT AND I HAVE NO OBJECTION TO ISSUE FOR A SEPARATE PASSPORT FOR MY
SON/DAUGHTER.
PARTICULARS OF THE CHILD:
NAME : _____________________________________________________________________________
DATE OF BIRTH : (dd/mm/yy) _______________/_________________/_________________________
SEX : (circle one)

MALE

FEMALE

PLACE OF BIRTH IN INDIA : (CITY) ____________________________________________________

(STATE) ___________________________________________________
MOTHERS NAME : ___________________________________________________________________
FATHERS NAME : ____________________________________________________________________

PARENTS SIGNATURE: ______________________________________

(FATHER OR MOTHER)

THIS DECLARATION TO BE NOTARIZED BY

NOTARY PUBLIC

ATTESTATION OF THE CONSULAR

OFFICIAL OF INDIAN MISSION
ABROAD