ANNEXURE ‘D’

DECLARATION BY APPLICANT’S PARENT(S) OR GUARDIAN FOR

ISSUE OF PASSPORT TO MINOR

We, TUSHAR KISHOR CHOUDHARI and PRACHI TUSHAR CHOUDHARI, resident of D/85,
Road No.3, Gaothan, Near Chembur Post Office, Chembur, Mumbai-400071, hereby affirm that
the particulars given below are of AADYA TUSHAR CHOUDHARI, daughter of
Shri TUSHAR KISHOR CHOUDHARI and Smt PRACHI TUSHAR CHOUDHARI, of whom we are
the parents/guardian.

Particulars of minor child

Name : AADYA TUSHAR CHOUDHARI
Date of birth : 26/FEB/2019
Place of birth : PANVEL, NAVI MUMBAI, MAHARASHTRA
2. The minor child mentioned above is a citizen of India.
3. We undertake the entire responsibility for her expenses.
4. 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.
5. It is also certified that we are holding valid India passport(s).

Place: Mumbai
Date:

Signature of father Signature of mother

Passport No. P1665578 Passport No. N1049087