FORM - 17 [DECLARATION BY ONE OF THE PARENTS FOR OBTAINING A PASSPORT IN INDIA FOR HIS/HER MINOR CHILD/CHILDREN]

Consulate General of India Jeddah -SWORN AFFIDAVIT

[To be submitted in duplicate with copy/copies of birth certificate of child(ren), Passport and Iqama copy of the deponent parent]

SHAIK MOHAMMAD IRSHAD I, ______________________________________________, holder of Passport No. ____________ issued at_________________on ________________residing at_________________ Saudi Arabia, [Mobile No. ___________________] do solemnly swear and affirm that: I am married to Mr./Mrs. ____________________________ son/daughter of __________________. He/she is presently residing at _____________________________________________________________________________ __________________________ . My wife/husband is holding an Indian Passport No. _________________ issued on _____________ at ______________. There is no Indian passport(s) in the name (s) of our child/children listed below: Sl. No. 1. 2. 3. His/her/their name(s) is/are not included in mothers/fathers passport. The passport(s) is/are required by the child/children for visiting Saudi Arabia to stay with me. A copy of my passport will be submitted along with new passport application. I convey my consent for obtaining passport(s) for my child/children listed above. This affidavit is true and that it conceals nothing and no part of it is false. We understand that we are liable to be prosecuted if this affidavit or any part of it is in anyway found to be incorrect or false. Signature of the Parent Name Date of Birth Sex Relationship

Sworn and Signed before me. Seal and Signature of the Consular Officer