As per new Passport Amendment Rules 2016 dated 23.12.2016 issued by Govt of India
Annexure-‘I’
DECLARATION BY APPLICANT GENETIC PARENT(S) FOR ISSUE OF PASSPORT TO THE CHILD
BORN THROUGH SURROGACY
(On Plain Paper)
I/we…………………………………………………………………………………..(name of the genetic parent(s)
applying for passport of minor child) solemnly declare and affirm the following:
1. That I/We am/are the genetic mother/father/parents of ………………………………… ………………………..(name
of the minor child) who was born through surrogacy, and who is a minor and on whose behalf I/We have made an
application for his/her passport.
2. That I/we only am/are taking care of ……………………………………………. (name of the minor child) and he/she
is exclusively in my/our physical custody since his/her birth.
3. I/We also affirm that in the case of any complaint or any litigation (civil/criminal) arising due to issue of a passport to ……………………………………..(name of the minor child) born through surrogacy, I/We shall be solely
responsible for defending the case and not the Passport Issuing Authority.
Date:
Place:
Signature & Address of the Parent (s)/
Guardian(s) applying for the Passport
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