Date: 10th May, 2022

From,

Ranganatha P & Shashikala K

#20, “Ammaji Nilaya, 6th Cross,
CTR Layout, Roopena Agrahara,
Bengaluru - 560068
Mobile No: +91-9449526536

To,

Passport Seva Kendra

Sai Arcade, Devarabisanahalli,
56/P, Marathahalli - Sarjapur Outer Ring Rd,
Bengaluru, Karnataka 560103

Subject: Authorization for submission of passport application to my minor son

Dear Sir/ Madam,

This to inform, that we’re not existing Passport holders yet.

Nonetheless, I hereby authorize my minor son (Gagan R), of the above residential address, whose
signature is attested below, for the passport to be issued with successful verification of the documents.

Kindly request to your goodself to accept my minor son’s passport application form from the above
mentioned authorised representative of mine.

Thanking you,

Yours faithfully,

(Name of the applicant)

Signature of authorised representative :

Name of the authorised representative:
Above name and signature verified by:
Signature of the applicant:
Name of the applicant: