Indian Passport ANNEXURE ‘L’

SPECIMEN AFFIDAVIT FOR A PASSPORT IN LIEU OF LOST/ DAMAGED PASSPORT

(This affidavit is to be executed on non-judicial stamp paper of minimum value in the presence of First Class Judicial Magistrate or Executive Magistrate/Notary Public on the following points)

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 & arrival stamps

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 expense 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: ………………….. Deponent

Affirm before First Class Judicial Magistrate or Executive Magistrate/ Notary Public

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Indian Passport Form

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Indian Passport ANNEXURE ‘J’

SPECIMEN VERIFICATION CERTIFICATE (To be given {in Duplicate* along with Standard Affidavit as at Annexure “I"} 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 (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 ...

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...

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