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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...
ANNEXURE E
SPECIMEN DECLARATION OF THE APPLICANT ON A PLAIN PAPER
ANNEXURE F
SPECIMEN DECLARATION OF APPLICANT FOR OBTAINING A PASSPORT IN LIEU OF LOST/ DAMAGED PASSPORT