Declaration: Date of Issue .

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Declaration

Date of issue..

I/we do hereby declare that I/we .passport nodate of birth.is/are


living in . My/our son(s)/daughter(s) name is/are (Mention all sons
& daughters names who are/is unable to bear the cost/taking my/our responsibility) are unable
to bear my/our expenditure. So, I/we completely dependent on my/our son/daughter living in
Italy named passport no.address
Italy)and he/she is bearing all of my/ our expenditures. This is why
I/we would like to go Italy to my/our son/daughter and stay with him/her permanently.

Thanking you

Name & signature (Seal & signature Chairman/commissioner)

Name & signature

(2nd applicant if any)

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