Passport Annexure I — Genetic Parent Declaration (Surrogacy) — Uttarakhand

PASSPORT ANNEXURE I

(Declaration by Genetic Parent(s) for Passport of Child Born Through Surrogacy)

(On plain paper — No stamp paper/notarisation required)

Date: 5 April 2026

Place: ________

I/We, ________, do hereby declare that:

Genetic Parent 1 Details:

Name: ________

Address: ________

Child's Details:

Name: ________

Date of Birth: ________

Place of Birth: ________

Surrogacy Details:

Surrogacy Agreement Date: ________

Hospital/Clinic: ________

1. The above child was born through the surrogacy process.

2. We are the genetic parents of this child.

3. This child is a citizen of India.

4. We give our consent for the issuance of passport for this child.

5. We declare that all information given above is true and correct.

6. We are aware that legal action may be taken under the Passports Act 1967 for any false information.

________ (Signature): _______________

Note: As per 2020-21 reforms, this declaration is valid on plain paper.