Annexure 'G': Declaration By Applicant Parent/ Guardian If Passport Is For Minor When One Parent Has Not Given Consent

ANNEXURE 'G'
DECLARATION BY APPLICANT PARENT OR GUARDIAN IF PASSPORT IS FOR MINOR WHEN ONE PARENT HAS NOT GIVEN CONSENT
(In the form of a sworn affidavit before Judicial Magistrate or Executive Magistrate on non-judicial stamp paper of minimum value)
I/We…………………………………………………………………………………..(name of the Parent/Guardian applying for passport) solemnly declare and affirm the following:
1. That I/We am/are the mother/father/parents/guardians of………………………………… ………………………..(name of the minor child) who is a minor and on whose behalf I/We have made an application for his/her passport.
2. Signature/Consent of Mr./Mrs.……………………………………………………..(name of the father/mother) who is father/mother/ parents of the child has not been obtained by me for the following reasons:
3. That I/We only am/are taking care of…………………………………………………….. (name of the minor child) and he/she is exclusively in my physical custody.
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