Passport Application Form M (Page 3 of 3) in pdf

Passport Application Form M Page 3

Parent’s consent. See Note 2

Supplementary Information

I (name) _______________________________________

______________________________________________

the (relationship) ______________________ of (name)

______________________________________________

______________________________________ hereby

______________________________________________

give my consent for him/her to hold a passport.

______________________________________________

Signature ______________________________________

______________________________________________

Declaration

To be signed by all applicants

I, the undersigned, hereby apply for the issue of a passport. I declare that the information provided in this application is correct to

the best of my knowledge and belief and that I have not lost or renounced the status of Citizen of Antigua and Barbuda. I further

declare that any and all previous passports granted to me have been surrendered, other than the passport or travel document with

the number specified in section of this form, which is now attached, and that no other application for a passport has been made

since the attach passport or travel document was issued to me.

Date: __________________

IMPORTANT - KEEP WITHIN BOX.

FOR OFFICAL USE ONLY

Failure to comply with this instruction will invalidate

the application

Amount of Fee paid

Passport Application Form M Page 3