Application Form For Indian Passport At An Indian Mission/post (Page 4 of 4) in pdf

Application Form For Indian Passport At An Indian Mission/post Page 4

citizenship of India.

The information given by me is true and I am solely responsible for its accuracy. I am aware that it is an

offence under the Passport Act, 1967 to furnish any false information or to suppress any material

information with a view to obtaining passport or any other travel document.

Signature/Thumb Impression of applicant

(Left Hand T.l. if male and right Hand T.l. if female)

Date…………………/Place……………………

27. In case of minors, following passport particulars of both parents must be given:

Mother

Father

(a) Passport No. :

(b) Date of Issue :

…………………………….

(d) If parents have applied for

A passport, please give

File No & date……………………………..

………………………………….

28 Declaration of Parents or Guardian if passport is for minor : (To be signed by both Parents or Guardian)

We affirm that the particulars given above are in respect of (Name) …………………………..

Son / daughter of Smt………………………………….Sh……………………………………………..

of whom we are the Parents / Guardian. We undertake the entire responsibility for his/her expenses. 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. It is also certified that the name

of the child mentioned is not included in passport of either parent.

………………………………………………..AND…………………………………OR……………….

Mother

Father

Guardian

Name & Signature/ T.l of both the Parents/Guardian (left hand T.l. if male and Right hand T.l .if female)

Place……………………………….Date……………………………

29. Specimen signature or T.l.within the Space given below :

FOR OFFICE USE ONLY

Application Form For Indian Passport At An Indian Mission/post Page 4