Declaration of Parent/Guardian for Minor Passports (one parent 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
(On non-judicial stamp paper of minimum value)

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