ANNEXURE - 7
SOLEMN DECLARATION AND UNDERTAKING
For General Category
I, Mr./Mrs./Miss______ S/o./W/o./D/o._______ an Indian citizen, do hereby solemnly affirm and declare as under:
1. I am aware that, as per Government of India policy, a person can perform Haj only "Once in a Lifetime"
through the Haj Committee of India (HCol).
2. I have never performed Haj through the HCol in the past, and hence I am eligible to apply for Haj-2023. I
am aware that repeaters are not eligible for Haj 2023 and if it is detected at any stage that I have already
performed Haj through HCoI, my seat shall be cancelled and the entire amount deposited shall be
forfeited.
3. I have read / understood thoroughly the Guidelines for Haj 1444 (H) — 2023 (C.E.), particularly with
reference to eligibility, cost, payments and confirmation, cancellation, refunds, embarkation points,
vaccination and health requirements before flight, baggage, flight, and accommodation in Kingdom of
Saudi Arabia, and I undertake to abide by the same.
4. I hereby authorize HCol to send SMS to my mobile phone number, even if I am on the DND registry.
5. The particulars given by me in HAF, the solemn declaration, and the undertaking are true and correct to
the best of my knowledge. I do hereby affirm and declare that in the event I have suppressed material
information or given a false / incorrect declaration / undertaking, HCoI shall forfeit the amount deposited
by me and I shall be liable for prosecution.
6. I am aware that HCol reserves the right to change the Embarkation point opted by me. In such a case, I
shall abide by the decision of HCol and shall not show any resentment, whatsoever, against the decision
of HCoI.
7. I am ready to pay extra charges, as levied by the KSA Haj authorities, for the endorsement of my Haj visa.
8. I/We understand that the HCoI works without profit motive and does not attract the provisions of the
Consumer Protection Act, 2019.
9. Further, we understand that the Courts of Greater Mumbai alone shall have jurisdiction in all matters of
dispute.
10. I understand that if I am found carrying khas-khas, viagra-tablets, sexual oil and creams, synthetic capore,
cystone, khammera, gutkha, khaini, gul, peppermint, or narcotics in any form, my candidature shall be
cancelled. Besides, I will be penalized for carrying banned items as per the prevailing regulations of Saudi
Arabia, and I will be liable for deportation to India from KSA at any stage of Haj.
11. I hereby agree that the Rubat and metro transport facilities will be subject to the terms and conditions of
KSA, and that if this is not possible, I will be obligated to pay charges for the services provided to me.
12. I do not have any criminal prosecutions pending against me.
13. I am medically fit to perform the Haj pilgrimage and do not have any contagious diseases.
Date: _________________
Place: ___________________
___________________________________
Signature / Thumb impression of the applicant.
ANNEXURE - 6
SOLEMN DECLARATION AND UNDERTAKING
For General / Lady Without Mehram (LWM) Category
I, Mr./Mrs./Miss _____ S/o./W/o./D/o._______, an Indian citizen, do hereby solemnly affirm and declare as under:
1. I am aware that, as per Government of India policy, a person can perform Haj only "Once in a Lifetime"
through the Haj Committee of India (HCoI).
2. I have never performed Haj through the HCoI in the past, and hence I am eligible to apply for Haj-2023. I
am aware that repeaters are not eligible for Haj 2023 and if it is detected at any stage that I have already
performed Haj through HCoI, my seat shall be cancelled and the entire amount deposited shall be
forfeited.
3. I have read / understood thoroughly the Guidelines for Haj 1444 (H) – 2023 (C.E.), particularly with
reference to eligibility, cost, payments and confirmation, cancellation, refunds, embarkation points,
vaccination and health requirements before flight, baggage, flight, and accommodation in Kingdom of
Saudi Arabia, and I undertake to abide by the same.
4. I hereby authorize HCoI to send SMS to my mobile phone number, even if I am on the DND registry.
5. The particulars given by me in HAF, the solemn declaration, and the undertaking are true and correct to
the best of my knowledge. I do hereby affirm and declare that in the event I have suppressed material
information or given a false / incorrect declaration / undertaking, HCoI shall forfeit the amount deposited
by me and I shall be liable for prosecution.
6. I am aware that HCoI reserves the right to change the Embarkation point opted by me. In such a case, I
shall abide by the decision of HCoI and shall not show any resentment, whatsoever, against the decision
of HCoI.
7. I am ready to pay extra charges, as levied by the KSA Haj authorities, for the endorsement of my Haj visa.
8. I/We understand that the HCoI works without profit motive and does not attract the provisions of the
Consumer Protection Act, 2019.
9. Further, we understand that the Courts of Greater Mumbai alone shall have jurisdiction in all matters of
dispute.
10. I understand that if I am found carrying khas-khas, viagra-tablets, sexual oil and creams, synthetic capore,
cystone, khammera, gutkha, khaini, gul, peppermint, or narcotics in any form, my candidature shall be
cancelled. Besides, I will be penalized for carrying banned items as per the prevailing regulations of Saudi
Arabia, and I will be liable for deportation to India from KSA at any stage of Haj.
11. I hereby agree that the Rubat and metro transport facilities will be subject to the terms and conditions of
KSA, and that if this is not possible, I will be obligated to pay charges for the services provided to me.
12. I do not have any criminal prosecutions pending against me.
13. I am medically fit to perform the Haj pilgrimage and do not have any contagious diseases.
Date: _________________
Place: ___________________
___________________________________
Signature / Thumb impression of the applicant.
ANNEXURE - 4
SOLEMN DECLARATION AND UNDERTAKING
For Category (Age 70+ applicant)
I, Mr./Mrs./Miss _____ S/o./W/o./D/o._______, an Indian citizen, do hereby solemnly affirm and declare as under:
1. I have already attained the age of 70 years as of the closing date for submission of the application form,
and my date of birth, as per my international passport, is __________.
2. I am also aware that Qurrah (draw of lots) will be held within the Category if applications received under
the Category are more than the allotted quota of the State. Hence, I shall not claim selection in such a
situation as a matter of right.
3. I have never gone to Haj either through the Haj Committee of India (HCoI), a private tour operator, or any
other means. Thus, this is my first Haj journey in my entire life. If it is detected at any stage that I have
already performed Haj, my seat shall be cancelled at any stage and the entire amount deposited shall be
forfeited.
4. Mr./Mrs./Miss_________ S/o./W/o./D/o.________, aged ___________years, an Indian citizen who is my
relative i.e., my Husband / Wife / Brother / Sister / Son / Daughter / Son-in-law / Daughter-in-law/ Grand
Son / Grand Daughter/ Nephew / Niece, shall be my companion.
6. I am aware that HCoI reserves the right to change the Embarkation Point opted by me. In such a case, I
shall abide by the decision of HCoI and shall not show any resentment whatsoever against the decision
of HCoI.
7. I/We undertake and mutually agree to take care of each other and belongings of each other during entire
Haj journey.
8. I/We have read / understood thoroughly the Guidelines for Haj 1444 (H) – 2023 (C.E.), particularly with
reference to eligibility, cost, payments and confirmation, cancellation, refunds, embarkation points,
vaccination and health requirements before flight, baggage, flight, and accommodation in the Kingdom of
Saudi Arabia, and undertake to abide by the same.
9. I/We understand that the HCoI works without profit motive and does not attract the provisions of the
Consumer Protection Act, 2019. Further, we understand that the Courts of Greater Mumbai only shall
have jurisdiction in all matters of dispute.
10. I/we hereby authorize HCoI to send SMS to our mobile phone numbers, even if we are on the DND
registry.
11. The particulars given by us in HAF, the solemn declaration, and the undertaking are true and correct to
the best of our knowledge. I/We do hereby affirm and declare that in the event I/We have suppressed
material information or given a false / incorrect declaration or undertaking, HCoI shall forfeit the amount
deposited by us and I/We shall be liable for prosecution.
12. I/We are aware that HCoI reserves the right to change the embarkation point opted by me. In such a case,
I/We shall abide by the decision of HCoI and shall not show any resentment, whatsoever, against the
decision of HCoI.
13. I am ready to pay extra charges, as levied by the KSA Haj authorities, for the endorsement of my Haj visa.
14. I understand that if I am found carrying khas-khas, viagra-tablets, sexual oil and cream, synthetic capore,
cystone, khammera, gutkha, khaini, gul, peppermint, or narcotics in any form, my candidature shall be
cancelled. Besides, I will be penalized for carrying banned items as per the prevailing regulations of Saudi
Arabia and I will be liable for deportation to India from KSA at any stage of Haj.
15. I hereby agree that the Rubat and metro transport facilities will be subject to the terms and conditions of
KSA, and that if this is not possible, I will be obligated to pay charges for the services provided to me.
16. I do not have any criminal prosecutions pending against me.
17. I am medically fit to perform the Haj pilgrimage and do not have any contagious diseases.
Date: _____________________
Place: _____________________
____________________________________________
Signature / Thumb impression of the applicant (Age 70+ pilgrim)
Date: ____________________
Place: ____________________
____________________________________________
Signature / Thumb impression of the co-applicant (companion)
ANNEXURE - 5
SOLEMN DECLARATION AND UNDERTAKING
For Repeater in case of Mehram (Male Companion) of Lady Pilgrim / Companion of age 70+ pilgrim
I, Mr./Mrs./Miss _____ S/o./W/o./D/o._______, an Indian citizen, do hereby solemnly affirm and declare as under:
1. I am aware that, as per Government of India policy, a person can perform Haj only "Once in a Lifetime"
through the Haj Committee of India (HCoI), and that this condition is waived only for the Mehram (male
companion) of a lady pilgrim / companion of age 70+ pilgrim, if no other Mehram / companion who has
not performed Haj through the HCoI is available.
2. I hereby declare that I performed Haj in the past through the HCoI in the year(s) ______________.
3. I declare that no other Mehram (Male Companion)/Companion of age 70+ pilgrim, who has not performed
Haj through the HCoI earlier is available to accompany the following co-applicant(s):
4. __________________________________________________________________________________
5. __________________________________________________________________________________
6. __________________________________________________________________________________
7. __________________________________________________________________________________
8. I am aware that if the concerned Lady Pilgrim(s) or 70+ pilgrims cancels her or their pilgrimage, my seat
as Repeater Mehram (male companion) or 70+ pilgrim companion of accompanying the lady member(s)
or 70+ pilgrims will be automatically cancelled.
9. I have read / understood thoroughly the Guidelines for Haj 1444 (H) – 2023 (C.E.), particularly with
reference to eligibility, cost, payments and confirmation, cancellation, refunds, embarkation points,
vaccination and health requirements before flight, baggage, flight, and accommodation in the Kingdom of
Saudi Arabia, and I undertake to abide by the same.
10. I hereby authorize HCoI to send SMS to my mobile phone number, even if I am on the DND registry.
11. I/We understand that the HCoI works without profit motive and does not attract the provisions of the
Consumer Protection Act, 2019. Further, we understand that the Courts of Greater Mumbai only shall
have jurisdiction in all matters of dispute.
12. The particulars given by me in HAF, the solemn declaration, and the undertaking are true and correct to
the best of my knowledge. I do hereby affirm and declare that in the event I have suppressed material
information or given a false / incorrect Declaration / Undertaking, HCoI shall forfeit the amount deposited
by me and I shall be liable for prosecution.
13. I am aware that HCoI reserves the right to change the embarkation point opted by me. In such a case, I
shall abide by the decision of HCoI and shall not show any resentment, whatsoever, against the
decision of HCoI.
14. I am ready to pay extra charges, as levied by the KSA Haj authorities, for the endorsement of my Haj
Visa.
15. I understand that if I am found carrying khas-khas, viagra-tablets, sexual oils and creams, synthetic
capore, cystone, khammera, gutkha, khaini, gul, peppermint or narcotics in any form, my candidature
shall be cancelled. Besides, I will be penalized for carrying banned items as per the prevailing
regulations of Saudi Arabia and I will be liable for deportation to India from KSA at any stage of Haj.
16. I hereby agree that the Rubat and metro transport facilities will be subject to the terms and conditions of
KSA, and that if this is not possible, I will be obligated to pay charges for the services provided to me.
17. I do not have any criminal prosecutions pending against me.
18. I am medically fit to perform the Haj pilgrimage and do not have any contagious diseases.
Date: _________________________
Place: _________________________
Signature / Thumb impression of the applicant.
ANNEXURE - 8
SOLEMN DECLARATION AND UNDERTAKING
For Pilgrim below 18 years of age as on date of departure.
I, Mr./Mrs./Miss _____ S/o./W/o./D/o._______, an Indian citizen and legal guardian/father/mother of
Master/Miss……………………accompanied me during Haj pilgrimage between……(date)……..………..to
………(date)……..., do hereby solemnly affirm and declare on behalf of Master/Miss……………….…….as under:
1. I will be solely responsible for fulfillment of statutory provisions, liability and conducts of
Master/Miss………………..who is travelling with me during Haj pilgrimage between…(date)……..and
…(date)…….., during whole Haj period in Kingdom of Saudi Arabia (KSA) and within India.
2. I hereby declare that I will not claim any refunds for discounts or other benefits offered by various service
providers in respect of Master/Miss................., except those offered under package of Haj Committee of
India (HCoI).
3. I am aware that as per Government of India Policy, a person can perform Haj only "Once in a Lifetime"
through the HCoI, and this will be applicable even in the case of Master/Miss……………….……..
4. That Master/Miss……………….…….have never performed Haj through HCoI in the past and hence
he/she is eligible to apply for Haj-2023. I am aware that repeaters are not eligible for Haj-2023 and if it is
detected at any stage that Master/Miss……………….……have already performed Haj through the HCoI,
his seat shall be cancelled and the entire amount deposited shall be forfeited.
5. I have read / understood thoroughly the Guidelines for Haj 1444 (H) – 2023 (C.E.), particularly with
reference to Eligibility, Cost, Payments and Confirmation, Cancellation, Refunds, Embarkation Points,
Vaccination and Health Requirements Before Flight, Baggage, Flight, and Accommodation in Kingdom of
Saudi Arabia, and undertake that these provisions will be abide by me on behalf of
Master/Miss……………….……..
6. I hereby authorize HCoI to send SMS to my mobile phone number, even if I am on the DND registry.
7. The particulars given by me in HAF, the solemn declaration, and Undertaking are true and correct to the
best of my knowledge. I do hereby affirm and declare that in case I have suppressed material information
or given a false / incorrect Declaration / Undertaking, HCoI shall forfeit the amount deposited by me/legal
guardian/father/mother of Master/Miss……………….……. and I shall be liable for prosecution.
8. I am aware that HCoI reserves the right to change the Embarkation Point opted for by me on behalf of
Master/Miss……………….…….. In such a case, I shall abide by the decision of HCoI and shall not show
any resentment, whatsoever, against the decision of HCoI.
9. I am ready to pay extra charges, as levied by the KSA Haj authorities, for the endorsement of my Haj visa.
10. I/We understand that HCoI works without profit motive and does not attract the provisions of Consumer
Protection Act, 2019.
11. Further, we understand that the Courts of Greater Mumbai only shall have jurisdiction in all matters of
dispute.
12. I understand that if I or Master/Miss……………….…….is found carrying khas-khas, viagra-tablets, sexual
oil and cream, synthetic capore, cystone, khammera, gutkha, khaini, gul, peppermint or narcotics in any
form my/his candidature shall be cancelled. Besides, I will be penalized for carrying banned items as per
the prevailing regulations of Saudi Arabia and I and Master/Miss……………….…….will be liable for
deportation to India from KSA at any stage of Haj.
13. I hereby undertake that the facilities for Rubat & metro transport will be subject to terms & conditions of
KSA and in the event that it is not feasible, I will abide to pay charges for the facilities provided to me.
14. Master/Miss……………….……. does not have any criminal prosecution pending against him/her.
15. Master/Miss……………….…… is medically fit to perform the Haj Pilgrimage and does not have any
contagious disease.
Date: ____________________
Place: ___________________
Signature / Thumb impression of legal guardian/father/mother of minor applicant
