General Declaration

Operator:
Marks of Nationality and Registration:	Flight No:	Date:
Departure From (Place):	Arrival At (Place):
Departure Time (Expected):	Arrival Time (Expected):
Contact Details (Name):
Telephone No:	Email Address:

CREW MANIFEST
	SURNAME	GIVEN NAME	ROLE	BIRTH DATE	BIRTH PLACE	PASSPORT COUNTRY CODE OF ISSUANCE AND NUMBER
1

PASSENGER MANIFEST
	SURNAME	GIVEN NAME	BIRTH DATE	BIRTH PLACE	PASSPORT COUNTRY CODE OF ISSUANCE AND NUMBER
1

Declaration of Health	For Official Use Only
Persons on board known to be suffering from illness other than airsickness or the effects of accidents, as well as those cases of illness disembarked during the flight: Any other condition on board which may lead to the spread of disease: Details of each disinsecting or sanitary treatment (place, date, time, method) during the flight. If no disinsecting has been carried out during the flight give details of most recent disinsecting: Signed, if required (Crew member concerned):

Declaration of Health

For Official Use Only

Persons on board known to be suffering from illness other than airsickness or the effects of accidents, as well as those cases of illness disembarked during the flight:

Any other condition on board which may lead to the spread of disease:

Details of each disinsecting or sanitary treatment (place, date, time, method) during the flight. If no disinsecting has been carried out during the flight give details of most recent disinsecting:

Signed, if required (Crew member concerned):

I declare that all statements and particulars contained in this General Declaration, and in supplementary forms required to be presented with this General Declaration, are complete, exact and true to the best of my knowledge and that all through passengers will continue/have continued on the flight.

NAME and SIGNATURE (Authorized Agent or Pilot-in-command):