Written Consent For Child Under 18 Years Traveling With Only One Parent Or Without Either Parent printable pdf download

Written Consent For Child Under 18 Years Traveling With Only One Parent Or Without Either Parent

WRITTEN CONSENT FOR CHILD UNDER 18 YEARS

TRAVELING WITH ONLY ONE PARENT OR WITHOUT EITHER PARENT

TO WHOM IT MAY CONCERN:

I(WE) AUTHORIZE THE MINOR

NAME

PASSPORT NO.

DATE OF BIRTH

TRAVEL TO

FROM

Purpose of His / Her Trip is

□ ACCOMPANIED BY THE FOLLOWING PERSON(S);

Name

（ Relation

)

Address

DATE OF BIRTH

TEL

PASSPORT NO.

□ UNDER THE RESPONSIBILITY OF

ACCOMPANIED PARENT’S DATE OF BIRTH

PASSPORT NO.

□ REFERENCE(ex : HOTEL)

Name

( Relation HOTEL / OTHERS

)

Address

TEL

FATHER(PRINT NAME)

MOTHER(PRINT NAME)

CONTACT INFORMATION(PHONE NUMBER,etc.)

CONTACT INFORMATION (PHONE NUMBER,etc.)

SIGNATURE

DATE

WE SOLEMNLY SWEAR THAT HE / SHE SHALL COMPLY WITH THE LAWS AND REGULATIONS OF YOUR

COUNTRY,FEDERAL AND LOCAL,NEVER BE A BURDEN,ECONOMIC OR OTHERWISE,TO YOUR COUNTRY AND

DEPART COUNTRY WITHIN THE REASONABLE TIME NEEDED FOR TRANSFERS TO AND FROM JAPAN.

WE WOULD APPRECIATE IT VERY MUCH IF YOU WOULD TAKE THE NECESSARY ACTION TO GRANT HIS

/ HER THE ENTRY PERMIT TO YOUR COUNTRY AT YOUR EARLIEST POSSIBLE CONVENIENCE.

THANK YOU FOR YOUR COOPERATION.

Written Consent For Child Under 18 Years Traveling With Only One Parent Or Without Either Parent