Thursday, January 10, 2013

PASSPORT AFFIDAVITS


CHANGE OF NAME  
I. Following marriage, remarriage or divorce:
a) A woman applying for change of name/surname in existing passport due to
marriage must furnish:
i. Photocopy of the Husband’s passport, if any, and
ii. An attested copy of marriage certificate issued by Registrar of Marriage
OR an affidavit from the husband and wife along with a joint
photograph, (Specimen at Annexure D).
b) Divorcees applying for change of name OR for deletion of spouse’s name in
existing passport must furnish
i. Certified copy of Divorce decree.
ii. Deed poll/sworn affidavit (ANNEXURE ‘E’)
c) Re-married applicants applying for change of name/spouse’s name must
furnish:
i. Divorce deed/death certificate as the case may be in respect of first
spouse, and
ii. Document as at (a) above relating to second marriage.
II. In other circumstances for change of name, the applicant (both male and
female) should furnish:
i. Deed poll/sworn affidavit (ANNEXURE ‘E’).
ii. Paper cuttings of two leading daily newspapers in original (one daily
newspaper should be of the area of applicant’s permanent and present
address or nearby area).
ANNEXURE ‘A’
SPECIMEN AFFIDAVIT TO BE SUBMITTED BY ILLITERATE APPLICANTS AS PROOF OF DATE OF BIRTH
IN CASE NO OTHER DOCUMENT MENTIONED AT PARA A (b) OF SECTION IV  IS AVAILABLE
(To be executed on non-judicial stamp paper)
I …………………S/o w/o D/o ……………….. presently residing at ………………… hereby state
as follows:
I was born on ………………. at ……………… situated in the District. ………….. in the State of
………..  I have no documentary proof in support of my place and date of birth.
I do not possess any educational qualification and I am an illiterate person.
I take oath and solemnly declare/affirm that the particulars furnished by me above
are correct and that I have not concealed or misrepresented any facts. Place …………
Date …………..
Verified on this …………………… day of …………….. of the year ……………..  that the
contents of my above affidavit are true and correct to the best of my knowledge and
belief and nothing in material has been concealed there from.
The contents of the affidavit has been read out to me
Deponent
Attested
Signature and official seal of attesting authority
Note: Affidavit to be attested by the Magistrate/Notary
In case of notary, notarial stamp would be required
ANNEXURE ‘B’
ALL CENTRAL GOVERNMENT EMPLOYEES STATE GOVERNMENT EMPLOYEES,
EMPLOYEES OF STATUTORY BODIES AND PUBLIC SECTOR UNDERTAKINGS
AND THEIR DEPENDENT FAMILY MEMBERS ARE REQUIRED TO PRODUCE A
IDENTITY CERTIFICATE (STRIKE OUT PORTION NOT APPLICABLE)
(To be given in Duplicate on Original Stationery)
Certified that SHRI/SHRIMATI/KUM …………. Son/Wife of Shri …………………  of is a
temporary/permanent employee of this (office address) ……………. from ……. (date)
……. and is at present holding the post of  ………………..  Shri/Smt./Miss/Mst.
……………….is/are  a dependent family member(s) of Shri/Smt…………………………. and
his/her identity is certified. This Ministry/Department/Organization has no objection
to his/her acquiring Indian Passport.  The undersigned is duly authorized to sign this
Identity Certificate. I have read the provisions of Section 6(2) of the Passports Act,
1967 and certify that these are not attracted in case of this applicant.  I recommend
issue of an Indian Passport to him/her.   It is certified that this organization is a
central / State Government / Public Sector / undertaking / statutory body.  The
Identity Card Number of Shri/Smt (employee)…………………………is………………… Ref. No. &
Date ……………..                                                 Name,
Designation, address & Tel No.
 
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)
I, (name of single parent) solemnly declare and affirm as follows:
1.                 That I am the mother/father of  (name of the child) who is a minor
child 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
minor).
OR
            That no legally valid marriage ever existed between me and
Mr./Ms.(the father/mother the minor child)
OR
The father/mother of  (name of the child) has deserted me after
conception/ delivery
3. That (name of the minor) is exclusively under my care and custody
since separation/delivery.  
           Signature & address of Deponent
  Date:
(Sworn before the First Class Judicial Magistrate or Notary Public)   ANNEXURE ‘D’
SPECIMEN AFFIDAVIT TO BE SUBMITTED ALONG WITH APPLICATION FOR PASSPORT BY A WOMAN
APPLICANT FOR CHANGE OF NAME AFTER MARRIAGE (JOINT AFFIDAVIT TO BE SUBMITTED ALONG
WITH HER HUSBAND)
(To be executed on non-judicial stamp paper)
 
We    1………………………………………………………………………………
                                    (maiden name of wife)
         2.……………………………………………………………………………….
                        (name of husband)      
       solemnly declare and affirm as under:
1.That we are married under ……………………….Marriage Act/Rights/Customs and are
living together as married couple since……………………………………………
                                    (date of marriage)
2..That ……………………………….. would henceforth be known as …………………
    (maiden name of wife)                                                    (name of wife after
marriage)
      by virtue of our marriage.
3.That our joint photograph is affixed below.
 Date:
                                                                                    Signature & address of
Deponents
                                                                       
                                                                                                           
1……………………….
2………………………Note:       1.  This affidavit may be sworn before a Magistrate/Notary.
              2. The joint photograph of the couple is to be pasted on the bottom left
hand side of the affidavit paper and attested by the Magistrate/Notary with
his/her signature and rubber stamps (half on the photograph and half on
the affidavit)
               3.   Declaration 2 above to be ignored by applicants who seek
endorsement of name of spouse in respect of reissue of a previously issued
passport.    
ANNEXURE ‘E’
SPECIMEN AFFIDAVIT FOR CHANGE IN NAME/DEED POLL/SWORN
AFFIDAVIT
(On non-judicial stamp paper)
            By this deed I, the undersigned……………….(New Name) previously called
………………. (Old name), doing……………………(give profession or vocation) and resident
of …………………………(address) solemnly declare:-
1.       That for and on behalf of myself and my wife and children and remitter
issue wholly renounce/relinquish and abandon the use of my former name/surname
of ……………………….and in place thereof I do hereby assume from this date the
name/surname ……. and so that I and my wife, children and remitter issue may
hereafter be called, known and distinguished not by my former name/surname, but
assumed name/surname of ………………………
          2.       That for the purpose of evidencing such my determination declare that
I shall at all times hereafter in all records, deeds and writings and in all proceedings,
dealings and transactions, private as well as upon all occasions whatsoever use and
sign the name of …….. as my name/surname in place and in substitution of my
former name/surname.
3.       That I expressly authorize and request all persons in general and
relatives and friends in particular, at all times hereafter to designate and address
me, my wife, my children, remitter issue by such assumed name/surname of
…………………..accordingly.
4.       In witness whereof I have hereunto subscribed my former and adopted
name/surname of ………….. and ……… affix my signature and seal, if any, this
………………….. day of …………..Signed sealed and delivered by the above name
Former name……………
Date……
In the presence of:
          Name………………..                                             Name ………………….
          Address…………….                                             Address ………………..
(This deed poll/affidavit may be signed and attested in presence of a
Magistrate/Notary or Consular Officer in an Indian Mission abroad)
Note: In case of change of name, applicant should insert advertisements in two
reputed newspapers (one local newspaper of the area in which he/she is residing and
2
nd
 in newspaper of  the area of permanent address) and submit original newspapers
at time of applying for passport in his/her new name.
 
ANNEXURE ‘G’
DECLARATION OF APPLICANT PARENT OR GUARDIAN IF PASSPORT IS FOR
MINOR (one parent not given consent)  : IN THE FORM OF A SWORN
AFFIDAVIT BEFORE JUDICIAL MAGISTRATE ON NON-JUDICIAL STAMP
PAPER
I/We …………………………………………………………………….solemnly declare and affirms
as follows:
               (Name of the Parent/Guardian applying for passport)
1.       That I/We am/are the mother/father/parents/guardians of
…………………………………………………………..who is a minor child and on whose
behalf                                                   (Name of the Minor Child)
         I/We have made an application for his/her passport.
2.       Signature/Consent of Mr/Mrs…………………………………………………………………….who is
father/mother/parents of the child has not                            (Name of the
father/Mother)been obtained by me for the following reasons:
 3.       That I/We only am/are taking care of
………………………………………………………………………………he/she is             exclusively in my
physical custody.                                                        (Name of the minor child)
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
___________________________________________________________________
_________________________________________
ANNEXURE ‘H’
DECLARATION OF APPLICANT PARENT OR GUARDIAN IF PASSPORT IS FOR
MINOR: ON PLAIN PAPER
                              I/We affirm that the particulars given above are in respect of
(name of the child) …………………………………… son/daughter of Shri.
………………………………………………… and  Shrimati ……………………………………………………… of
whom I/we am/are the Parents/Single Parents/Applicant Parent/Guardians. He/She
is a Citizen of India. His/Her date of birth/place of Birth is ----------. I/We undertake
the entire responsibility for his/her expenses.  I/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 I/we am/are holding/not holding valid Indian passport(s) and the name of the
child mentioned is not included in Passport of either parent.                
_____________          /                 _________________        
  OR___________________
Father (Signature)                       Mother (Signature)             Legal Guardian
(Signature)___________________________________________________________________
_________________________________________
 
ANNEXURE ‘I’
AFFIDAVIT
(To be executed on appropriate non-judicial stamp paper and attested by a
Notary Public)
(One original and one self-attested photocopy)
I, name),________________Son of _________________________residing at
______________________Date of Birth______ being an applicant for issue of
passport, do hereby solemnly affirm and state as follows:
1.         That the names of my parents and spouse are as follows:
            (i)  Father                     :
            (ii) Mother                    :
            (iii) Wife/Husband         :
2.         That I am continuously resident at the above mentioned address
from……………………….
3.    That I am citizen of India by birth/descent/registration/naturalization and that I
have neither acquired the citizenship of another country nor have surrendered
or been terminated/deprived of my citizenship of India.
4.            That  I  have  not,  at  any  time  during  the  period  of  five  years  immediately
preceding the date of this affidavit, been convicted by any court in India for
any offence involving moral turpitude and sentenced in respect thereof to
imprisonment for not less than two years;
5.      That  no  proceedings  in  respect  of  any  criminal  offence  alleged  to  have  been
committed by me are pending before any criminal court in India;
6. That no warrant or summons for my appearance, and no warrant for my arrest,
has been issued by a court under any law for the time being in force, and that my
departure from India has not been prohibited by order of any such court; 7.  That I have never been repatriated from abroad back to India at the expense of
Government of India/I was repatriated from abroad back to India at the expense of
Government of India, but reimbursed expenditure incurred in connection with such
repatriation.
8.   That I will not engage outside India in activities prejudicial to the sovereignty
and integrity of India.
9.   That my departure from India will not be detrimental to the security of India.
10.  That my presence outside India will not prejudice the friendly relations of India
with any foreign country.
Place:                                                                                                                
                                            Date :
DEPONENT
VERIFICATION
Verified on…..(date) at …………. (place) that the contents of the above mentioned
affidavit are true and correct and nothing material has been concealed.
DEPONENT

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