ANNEXURE 'G' DECLARATION OF APPLICANT PARENT OR GUARDIAN IF PASSPORT IS FOR MINOR (one parent not given consent) : IN THE FORM OF A SWORN AFFIDAVIT BEFORE JUDICIAL MAGISTRATE ON NON-JUDICIAL STAMP PAPER I/We ...........................solemnly declare and affirms as follows: (Name of the Parent/Guardian applying for passport) 1. That I/We am/are the mother/father/parents/guardians of ........................who is a minor child and on whose behalf (Name of the Minor Child) I/We have made an application for his/her passport. 2. Signature/Consent of Mr./Mrs............................who is father/mother/parents of the child has not (Name of the father/Mother) been obtained by me for the following reasons: 3. That I/We only am/are taking care of ..............................he/she is exclusively in my physical custody. (Name of the minor child) 4. 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. Date : Signature & Address of the parent (s) guardian(s) applying for the Passport _________________________________________________________________________
