GOV E RNME NT OF I NDIA MI NI ST RY OF EXT E RNA L AF FAIRS CPV D IV ISI ON, DE LH I

ANNEXURE H DECLARATION OF APPLICANT PARENT OR GUARDIAN IF PASSPORT IS FOR MINOR We affirm that the particulars given above are in respect of Saisha Rawat daughter of Sh. Dikshit Rawat and Smt. Taranum Heera of whom we are the Parents/Single Parents/Applicant Parent/Guardians. She is a Citizen of India. Her date of birth/place of Birth is 06/02/2011, Noida. We undertake the entire responsibility for her expenses. We solemnly declare that she has not lost, surrendered or been deprived of her citizenship of India and that the information given in respect of 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.

_____________ ______ Father (Signature) (Signature)

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OR_____________

Mother (Signature)

Legal Guardian

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