Applicant?s photo to be attested by certifying authority

ANNEXURE 'B'

SPECIMEN VERIFICATION CERTIFICATE (FOR PASSPORT UNDER TATKAAL ONLY)

(On official letter head of verifying authority)

Verification Certificate

This is to certify that Sh./Smt./Kum. ............................. son/wife/daughter of ...................... whose personal particulars are given below, has good moral character and reputation and that after having read the provisions of Section 6(2) of the Passports Act, 1967, I certify that these provisions are not attracted in case of this applicant and I, recommend issue of an Indian Passport to him/her. Applicant has been staying at his/her address continuously for the last one year.

Date of Birth ......................................

Place of Birth ......................................

Educational Qualification ......................................

Profession (Govt./Private Service/Others) ......................................

Permanent Address ......................................

Present Address ......................................

Office Seal

Full Name .........................

Designation .....................

I Card No. ........................

(Enclose a photocopy of I Card)

Telephone No.

(O)......... ..........

(R)................

Mobile No..................

Fax No......................

E-mail Id....................

Notes:

1. The applicant's passport size photograph is also required to be affixed on the Verification Certificate and attested by the officer issuing the Verification Certificate with his/her signature and rubber stamp put in such a way that half the signature and stamp appear on the photograph and half on the certificate.

2. If the applicant has resided at more than one place during the last one year, then all previous addresses with the relevant dates should be mentioned.

3. This Verification Certificate may be got signed by any of the following:

(i) An Under Secretary/Deputy Secretary/Director/Joint Secretary/Add. Secretary/Special Secretary/Secretary/Cabinet Secretary to Government of India.

(ii) A Director/Joint Secretary/Additional Secretary/Special Secretary/Chief Secretary to a State Govt.

(iii) A Sub-Divisional Magistrate/First class Judicial Magistrate/Additional DM/District Magistrate of the district of residence of applicant.

(iv) A District Superintendent of Police, DIG/IG/DGP of the district of residence of applicant.

(v) A Major and above in the Army, Lt. Commander and above in the Navy and Sq. Leader and above in the Air Force.

(vi) The General Manager and above of a Public Sector Undertaking and the Reserve Bank of India.

(vii) All members of any All India Service or Central Service who are equivalent to or above the rank of an Under Secretary to the Government, i.e. drawing their pay in the level 11 and above of the pay matrix recommended by the 7th Central Pay Commission.

(viii) Resident Commissioners/Additional Resident Commissioners of all the State Governments based in Delhi.

(ix) Concerned Tehsildars or concerned SHOs for an applicant staying in the area under his/her jurisdiction.

4. Anyone who issues incorrect verification certificate may be prosecuted under section 12(2) of the Passports Act, 1967.

5. Section 6(2) of the Passports Act, 1967-

"Subject to the other provisions of this Act, the passport authority shall refuse to issue a passport or travel document for visiting any foreign country under clause (C) sub-section 5 of any one or more of the following grounds, and on no other ground, namely:

(a) that the applicant is not a citizen of India.

(b) that the applicant may, or is likely to, engage outside India in activities prejudicial to the sovereignty and integrity of India.

(c) that the departure of the applicant from India may, or is likely to, be detrimental to the security of India.

(d) that the presence of the applicant outside India may, or is likely to, prejudice the friendly relations of India with any foreign country.

(e) that the applicant has, at any time during the period of five years immediately preceding the date of his application, been convicted by a court of India for any offence involving moral turpitude and sentenced in respect thereof imprisonment for not less than two years.

(f) that criminal proceedings in respect of an offence alleged to have been committed by the applicant are pending before a court in India.

(g) that a warrant or summons for the appearance, or a warrant for the arrest of the applicant has been issued by a court under any law for the time being in force or that an order prohibiting the departure from India of the applicant has been made by any such court.

(h) that the applicant has been repatriated and has not reimbursed the expenditure.

(i) that in the opinion of the Central Government the issue of passport or travel document to the applicant will not be in the public interest.

OR

SPECIMEN VERIFICATION CERTIFICATE (To be given by Chairmen of Apex Business Organizations to the Owners, Partners or Directors of the companies having membership of the concerned chambers) (Official letter head of verifying authority)

Reference Number    Applicants'

Photo

(Verification Certificate issuing officer should attest the photograph of the applicant with his/her signature and rubber stamp in such a way that half the signature and stamp appear on the photograph and half on the certificate.)

Verification Certificate

This is to certify that Sh./Smt./Kum. ............................. son/wife/daughter of ...................... whose personal particulars are given below has good moral character and reputation and that after having read the provisions of Section 6(2) of the Passports Act, 1967, I certify that these provisions are not attracted in case of this applicant and I recommend issue of an Indian Passport to him/her. Applicant has been staying at his/her address continuously for the last one year.

Date of Birth ......................................

Place of Birth ......................................

Educational Qualification ......................................

Profession ......................................

Permanent Address ......................................

Present Address ......................................

Place

Office Address with location

Full Name ...................................

Designation .................................

Office Seal

Name of the Chamber ...................

Telephone No.

(O)...................

(R)...................

Mobile No....................................

Fax No...........................................

E-mail Id.........................................

Notes:

1. The applicant's passport size photograph is also required to be affixed on the Verification Certificate and attested by the officer issuing the Verification Certificate with his/her signature and rubber stamp put in such a way that half the signature and stamp appear on the photograph and half on the certificate.

2. If the applicant has resided at more than one place during the last one year then all previous addresses with the relevant dates should be mentioned.

3. Anyone who issues incorrect verification certificate may be prosecuted under section 12(2) of the Passports Act, 1967.

ANNEXURE 'C'

SPECIMEN DECLARATION BY APPLICANT'S PARENT OR GUARDIAN FOR ISSUE OF PASSPORT TO MINOR WHEN ONE PARENT HAS NOT GIVEN CONSENT

(On plain paper)

I/We ............................................... (name of the parent/guardian applying for passport) resident of ........................................................solemnly declare and affirm as under:-

(I) That I/we am/are the mother/father/parents/guardians of ......................(name of the minor child) who is minor and on whose behalf I/we have made an application for his/her passport.

(II) Signature/consent of Shri/Smt. ............................(name of the father/mother) who is the father/mother/parents of the child has not been obtained by me for the following one or more reasons:-

(a) The father/mother of the minor applicant is travelling abroad/is on sea/travelling in India and unable to file consent; or/and

(b) The father/mother is separated and no court case is pending before the court regarding divorce/marital dispute/custody of the child; or/and

(c) The father/mother has deserted and the whereabouts are not known; or/and

(d) There is an ongoing court case for divorce/custody of the minor child and the court has not given any order prohibiting the issue of passport without the consent of father/mother; or/and

(e) There is a court order for the custody of the minor child with a parent who is applying for the passport and consent of other parent (who has visitation rights) is not available or he/she is refusing to give consent/the other parent is not availing the visitation rights and his/her whereabouts are not known; or/and

(f) The parents are judicially separated and custody of the minor child has not been defined in the court's decree; or/and

(g) The father/mother of..........................(name of minor child) has deserted me after the conception/delivery. That.....................(name of minor child) is exclusively under my care and custody since separation/delivery.

(III) That I/we only am/are taking care of ............................(name of the minor child) and he/she is exclusively in my/our physical custody.

(IV) 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.

Signature of the parent(s)/

Guardian(s) applying for the Passport

Place:

Date:

Name(s):...........................................................

Aadhaar Card No. ..........................................; or

Voter ID Card No. ..........................................; or

Passport no. ..................................................

Annexure-'D'

SPECIMEN DECLARATION BY APPLICANT'S PARENT(S) OR GUARDIAN FOR ISSUE OF PASSPORT TO MINOR

(On plain paper)

I/we, ....................................................... resident of ..........................................hereby affirm that the particulars given below are of .....................(name of the child), son/daughter of Shri ................................and Smt. ......................... of whom I/we am/are the parents/guardian.

Particulars of minor child

Name:

Date of birth:

Place of birth:

2. The minor child mentioned above is a citizen of India.

3. I/We undertake the entire responsibility for his/her expenses.

4. 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.

5. It is also certified that I/we am/are holding/not holding valid India passport(s).

Place:

Date

Signature of father Passport No. ...............; or Aadhaar Card No. ........; or Voter ID Card No. .........;

Signature of mother Passport No. ..............; or Aadhaar Card No. ........;or Voter ID Card No. .........

Signature of legal guardian(s) Passport no. .....................; or Aadhaar Card No. ........; or Voter ID Card No. ......... Annexure E - ANNEXURE ''E'' Annexure-'E' SPECIMEN DECLARATION OF THE APPLICANT ON A PLAIN PAPER I, ........................... (name), son/daughter/wife of Shri ........................... residing at ................................... Date of Birth ........................... being an applicant for issue of passport, do hereby solemnly affirm and state the following: 1. That the names of my parents and spouse are as follows: (i) Father: (ii) Mother: (iii) Wife/Husband: 2. That I am a continuous resident at the above mentioned address from............................ 3. That I am a 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 declaration, 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 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: (Signature of applicant) Annexure F - ANNEXURE ''F'' Annexure-'F' SPECIMEN DECLARATION OF APPLICANT FOR OBTAINING A PASSPORT IN LIEU OF LOST/DAMAGED PASSPORT I............................... S/o., D/o., W/o. Shri........................... residing at .......................solemnly affirm as follows: 1. State how and when the passport was lost/damaged and when FIR was lodged at which Police Station and how many passports were lost/damaged earlier? 2. State whether you travelled on the lost/damaged passport, if so state flight number and date and port of entry into India? 3. State whether you availed of any TR concessions/FTs allowance and if so details thereof? 4. State whether non-resident Indian and if resident abroad, the details of the residence as follows: S. No. Name of the Country Length of residence From...... to ....... Page Nos. of passport bearing departure and arrival stamps 1.       2.       3.       5. State whether the Passport had any objection by the PIA and if so the details thereof. 6. State whether you were deported at any time at the expenses of the Government and if so was the expenditure incurred reimbursed to Government of India. I further affirm that I will take utmost care of my passport if issued and the Government will be at liberty to take any legal action under the Passports Act, 1967, if the lapse is repeated. Date: ....................... (Signature of applicant) Annexure G - ANNEXURE ''G'' Annexure-'G' MINISTRY/DEPARTMENT/OFFICE OF  No.............. dated...................   Applicants? Photo       (No Objection Certificate issuing officer should attest the photograph of the applicant with his/her signature and rubber stamp in such a way that half the signature and stamp appear on the photograph and half on the certificate.) NO-OBJECTION CERTIFICATE Shri/Smt./Miss.................................S/o. ....................................., who is an Indian national, is employed in this office as...............................from................ till date. This Ministry/Department/Office has no objection to his/her obtaining a passport. (Signature of Controlling/Administrative authority) Telephone/Fax/email............ Note:- (a) The officer authorized to issue NOC should sign with name and stamp and must provide contact details for verification by Passport Authority. (b) NOC will be valid for six months from date of issue. Annexure H - ANNEXURE ''H'' Annexure-'H' PRIOR INTIMATION (PI) LETTER FROM THE GOVERNMENT/PSU/STATUTORY BODY EMPLOYEE TO HIS/HER ADMINISTRATIVE OFFICE FOR SUBMISSION OF PASSPORT APPLICATION FOR HIMSELF/HERSELF (ON PLAIN PAPER) Place: .......................... Date: ........................... [To be addressed to the Controlling/Administrative Authority with full postal address] ...................................................................... ...................................................................... ........................................... PIN: ................... Tel: ............................................................. Fax: .............................................................. Email: ........................................................... Subject: Prior Intimation for Submission of Passport Application. Sir/Madam, I hereby give prior intimation that I am applying for an ordinary Passport to Regional Passport Office, ............................................................... 2. This is for your kind information and record. Yours faithfully, Signature: ................................................................. Name: ..................................................................... Date of Birth: ............................................................. Designation: .............................................................. Name of Office Where Working: ....................................... ................................................................................ Name of Organisation: ................................................... ................................................................................ Address of Present Office: ............................................... ................................................................................ ................................................................................ Residential Address: ......................................................... ................................................................................ ................................................................................ Annexure I - ANNEXURE ''I'' Annexure-'I' DECLARATION BY APPLICANT GENETIC PARENT(S) FOR ISSUE OF PASSPORT TO THE CHILD BORN THROUGH SURROGACY (On Plain Paper) I/we...............................................................................................(name of the genetic parent(s) applying for passport of minor child) solemnly declare and affirm the following: 1. That I/We am/are the genetic mother/father/parents of ....................................... .............................(name of the minor child) who was born through surrogacy, and who is a minor and on whose behalf I/We have made an application for his/her passport. 2. That I/we only am/are taking care of .................................................... (name of the minor child) and he/she is exclusively in my/our physical custody since his/her birth. 3. I/We also affirm that in the case of any complaint or any litigation (civil/criminal) arising due to issue of a passport to ............................................(name of the minor child) born through surrogacy, I/We shall be solely responsible for defending the case and not the Passport Issuing Authority. Date: Place: Signature & Address of the Parent (s)/ Guardian(s) applying for the Passport Print Judgement Hi! What would you like to log into? 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