As per the Passport (Amendment )Rule 2016 Issued by Govt of India on 23.12.2016 Declaration format for Issue of Passport to Minor Child is as follow
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 anyorder 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…………………………………………..
Annexure-‘D’
SPECIMEN DECLARATION BY APPLICANT’S PARENT(S) OR GUARDIAN FOR ISSUE OF
PASSPORT TO MINOR
(On plain paper)
I/we, ………………………………………………. resident of ……………………………………hereby affirm that the particulars given below are of …………………(name of the child), son/daughter of Shri …………………………..and Smt ……………………. of whom I/we am/are the parents /guardian.
Particulars of minor child
Name :
Date of birth :
Place of birth :
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 solemnly declare that he /she has not lost, surrendered or been deprived of his/her citizenship of India and
that the information given in respect of him/her in this application is true.
5. It is also certified that I/we am/are holding /not holding valid India passport(s).
Place:
Date
Signature of father Signature of mother Signature of legal guardian(s)
Passport No. ……………; or Passport No. …………..; or Passport no…………………; or
Aadhaar Card No……..; or Aadhaar Card No……..;or Aadhaar Card No……..; or
Voter ID Card No………; Voter ID Card No……… Voter ID Card No………