ANNEXURE ‘C’

SPECIMEN DECLARATION BY APPLICANT’S PARENT OR GUARDIAN FOR ISSUE OF PASSPORT TO MINOR WHEN ONE PARENT HAS NOT GIVEN CONSENT

(On plain paper)

 

I/We ……………………………………….. (name of the parent / guardian applying for passport) resident of ………………………………………………..solemnly declare and affirm as under :-

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

(II)               Signature/consent of Shri/Smt……………………….(name of the father/mother) who is the father/mother/parents of the child has not been obtained by me for the following one or more reasons:-

a.       The father/mother of the minor applicant is travelling abroad/is on sea/travelling in India and unable to file consent; or/and

b.      The father/mother is separated and no court case is pending before the court regarding divorce/marital dispute/custody of the child; or/and

c.       The father/mother has deserted and the whereabouts are not known; or/and

d.      There is an ongoing court case for divorce/custody of the minor child and the court has not given any order prohibiting the issue of passport without the consent of father/mother; or/and

e.      There is a court order for the custody of the minor child with a parent who is applying for the passport and consent of other parent (who has visitation rights) is not available or he/she is refusing to give consent/the other parent is not availing the visitation rights and his/her whereabouts are not known; or/and

f.        The parents are judicially separated and custody of the minor child has not been defined in the court’s decree; or/and

g.       The father/mother of……………………..(name of minor child) has deserted me after the conception/delivery. That…………………(name of minor child) is exclusively under my care and custody since separation/delivery.

(III)             That I/we only am/are taking care of ……………………….(name of the minor child) and he/she is exclusively in my/our physical custody.

(IV)             I/we also affirm that in the case of a court case arising due to issue of a passport to the minor child ……………..(name of the minor child), I/we would be solely responsible for defending the case and not the Passport Issuing Authority.

 

Signature of the parent(s)/ Guardian(s) applying for the Passport

 

Place:

Date:

Name(s): …………………………………………………..

Aadhaar Card No: ……………………………….…..; or

Voter ID Card No……………………………………; or

 

Passport no…………………………………………..