REPUBLIC OF THE PHILIPPINES DEPARTMENT OF JUSTICE BUREAU OF IMMIGRATION MAGALLANES DRIVE, INTRAMUROS 1002 MANILA TRAVEL DECLARATION AND ACCEPTANCE OF TERMS AND RISK FORM ‘A. TRAVEL DECLARATION B. TERMS AND CONDITION 1 acknowledge that the IATF- EID Resolution 57 s. 2020] 1. Tt is understood that the Boarding Pass issued by the airine dated 21 July 2020 requires the execution of a Declaration | constitutes that the passenger is fully aware of the IATF rules/ ‘acknowledging the risks involved in travelling, including risks | ___ regulation; Of delay as a result of COVID-19 pandemic. 2. It is understood that the airline crew/ personnel laid safety Precautions measures and health protocols to the passenger; I declare that I am medically and physically fit to travel | 3. A travel risk procedure is provided through the Airline check-in abroad as advised by my medical doctor/s. In case of | process; hospitalization or travel disruption abroad, Iikewise deciare | 4. All passengers shall undergo risk assessment protocols; that I have the means to support the expenses therefore. It is understood that the passenger comprehend all the terms and ‘condition provided in writing and orally and must demonstrate the ability to understand the current situation; and 6. Passenger shall undergo BI formalities and may be offioaded for ‘any other lavful causes. | declare that the above information is true and | accept that there is a risk when undertaking this travel. | have read and accepied all the terms and conditions provided above, and also understood the briefing, demonstration and Inset ont ngting and ply a the re- Checkin Sreeing, a= ‘Signature over printed name ale sighed NAME (As showy ine Passos) 0PEL EICGLEL- COW ca doe ee pT Peleren Sr 4%. inthe Priippines: AG 52 Gf 3p FP: brectr Co» fates Abad P22 Seon ty Ht tb 63/99 AE Cor A Ca Emotes on re 2 Carne oro in cave f Energon” org Le Esere) tb3re2 73309 Brief Explanation why need to travel: (Is essential?) Ineed h & Le care of my pared whe Ses Ge aes &£ Tires Airline Information (to be filled Airline staff/ crew): Sorunavon coun Dt rigneno: 2 2.929 Please indicate any information that shall assist the BI in thelr admission process (If any): Name of Airline Personnel: Date: "Note: Passengor shal submit this Form fo ihe immigration Officer during Bl departure formalies