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Consent Letter
To Whom It May Concern:
We, ____ _ , are the lawful custodial parents of
Child’s full name: ______ __________________
Date of birth (DD/MM/YY): _________________
Place of birth: ___________ ______________
Canadian passport number:_____________________________
Date of issuance of Canadian passport (DD/MM/YY): ________
Place of issuance of Canadian passport: __________________
___________ , has our consent to travel with
Full name of accompanying persons: ________________________________
Chinese passport number: __________________________________________
Date of issuance of passport (DD/MM/YY):_____________________________
Place of issuance of passport: ___________________________
to visit __China__ during the period of ________________ . During that period, ______ _ will be residing with _________ (relationship) at the following address:
Number, street address : _____________________________
City, province, country: ______________________________
Telephone numbers (residence): _______________________
Any questions regarding this consent letter can be directed to the undersigned at:
Number, street address: ________________ __
City, province, country: __ ___________________
Telephone numbers (work and residence): ____________________
Signature:_ ______________________________ Date:_________________

Signature:_______________________________ Date:_________________

Signed before me, __________________ (name of witness), on this ____day of ______, _____ at __________________________________ (name of location).
Signature: __________________ (name of witness)
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2010-5-21 -04:00
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