AUTHORITY LETTER

(POWER OF ATTORNEY)

TO,

THE CONSUL

EMBASSY OF CHILE

146 JOR BAGH, NEW DELHI-3

DEAR SIR,

BY THIS ACT, ON THIS DAY..... (PLEASE INDICATE HERE THE DATE), OF THE YEAR 2001, I, THE UNDERSIGNED MR./MS ..... (NAME OF THE APPLICANT), INDIAN NATIONAL , HOLDING PASSPORT NUMBER..... VALID UPTO......, HEREBY AUTHORIZE MR./MS.* ....(PLEASE INDICATE THE NAME, ORGANIZATION WHERE HE/SHE IS EMPLOYED , PASSPORT NUMBEROR IDENTITY CARD NUMBER OR SIMILAR DOCUMENTS OF THE PERSON BEING AUTHORIZED), TO SUBMIT THE VISA APPLICATION ALONG WITH ALL RELEVANT DOCUMENTS AT THE CONSULAR SECTION OF THE EMBASSY OF CHILE IN NEW DELHI.

MR./MS*/.....(PLEASE INDICATE HERE AGAIN THE NAME OF THE PERSON BEING AUTHORIZED) IS ALSO AUTHORIZED TO SIGN THE "CEDULA CONSULAR PARA TURISTAS" (A DOCUMENT WHICH FORMS PART OF THE VISA) AND TO RECEIVE THE PASSPORT DULY STAMPED WITH VISA.

                                                       (NAME ,SIGNATURE AND LEFT HAND THUMB

                                                                    IMPRESSION OF THE APPLICANT)

                                                     (PASSPORT SIZE PHOTOGRAPH OF APPLICANT TO BE PASTED HERE AND THEN TO BE DULY ATTESTED BY THE NOTARY)

PLACE:                                                                                   PHOTOGRAPH

DATE:                                                                                  TO BE PASTED HERE

NAME & SIGNATURE OF THE NOTARY

WITH OFFICIAL SEAL.

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