Indian Passport ANNEXURE �C�

 AFFIDAVIT TO BE SUBMITTED WITH THE APPLICATION FOR A PASSPORT OF A MINOR CHILD BY EITHER PARENT (WHO ARE SEPARATED BUT NOT FORMALLY DIVORCED) OR BY A SINGLE PARENT OF THE CHILD BORN OUT OF WEDLOCK

(To be executed on non-judicial stamp paper of minimum value)

I, ��������.. (name of single parent), solemnly declare and affirm the following:
1. That I am the mother/father of �������� (name of the child), who is a minor and on whose behalf I have made an application for his/her passport.
2. That I am judicially separated from the mother/father of ��������. (name of the child). OR
That no legally valid marriage ever existed between me and Mr./Ms. ��������� (name of father/mother of the minor child).
OR
The father/mother of ��������.. (name of the child) has deserted me after conception/ delivery.
3. That ��������. (name of the child) is exclusively under my care and custody since separation/delivery.

Date:

Signature & address of Deponent

(Sworn before the First Class Judicial Magistrate or Executive Magistrate or Notary Public)