GOVERNMENT OF INDIA MINISTRY OF EXTERNAL AFFAIRS CPV DIVISION, DELHI

ANNEXURE H DECLARATION OF APPLICANT PARENT OR GUARDIAN IF PASSPORT IS FOR MINOR: ON PLAIN PAPER We affirm that the particulars given above are in respect of (name of the child) NIHAL SHABEER son of Shri. SHABEER MUKKRIKKANDIYIL and Shrimati SHAMEEMA SHABEER of whom we are the Parents . He is a Citizen of India. His date of birth/place of Birth is 18 NOV 2008 KOZHIKODE. We undertake the entire responsibility for his expenses. We solemnly declare that he has not lost, surrendered or been deprived of his citizenship of India and that the information given in respect of him in this application is true. It is also certified that we are not holding valid Indian passport(s) and the name of the child mentioned is not included in Passport of either parent.

_____________ SHABEER MUKKRIKKANDIYIL Father (Signature)

_________________ SHAMEEMA SHABEER Mother (Signature)