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,.................................................... (Name)
..,....... " .................................... ,.... (Ad~.ress} .

. ..........)"·"···· .. .................................
~ ~.~

........./...... ./ 20 ...... (Date)

Controller General,
Department Of Immigration and Emigration,
No: 41, Ananda Rajakaruna Mawatha,
ColombolO .

.Reguestto l$sye a $eparate passportto child .

.We kindly inform that we do not have any objection in issuing a separate passport (Father's name}
.............................................................................. and (Mother's name) ......................................................... for
our child~ .................................... (Name of the child)

Thank you
I

Signature of Mother Signature of Father's

...................••) .... . ................. ~

NICJ:llu.mber /.Passport Number NIC Number /Passport Number