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VIAGS

VIETNAM AIRPORT GROUND SERVICES CO., LTD - VIAGS NOI BAI Page 1 of 1

GENERAL DECLARATION
(Outward / Inward)
Owner or Operator: VIETNAM AIRLINES
Marks of Nationality and Registration: VNA889 FlightNo: VN5591 Date: 05JUN2022
Departure from: CAN Arrival at: HAN
(Place) (Place)

FLIGHT ROUTING
(Place Column always to list origin, every en-route stop and destination)
Place NAMES OF CREW Number of Passengers
on this stage
CAN 1 CAPT PHAM ANH TUAN M 26/02/1984 C6039999 VN 27/11/2028 Departure Place: CAN
2 FO NGO NAM THAI M 16/05/1992 C9272482 VN 11/09/2030
3 POS BUI KIM ANH F 23/06/1990 C9600691 VN 28/10/2031 Embarking:
4 POS TRAN THI THU HUONG F 13/10/1994 C0738483 VN 09/07/2025 Through on
5 POS PHAM TUAN DAT M 31/12/1991 B8013247 VN 31/05/2023 same Flight:
6 FE BUI MANH HA M 21/03/1992 C3455604 VN 06/06/2027
7 MOS LE VAN VIET M 24/12/1994 C9131383 VN 05/06/2030
8 MOS NGUYEN THANH BINH DUONG M 10/01/1997 C2177178 VN 09/08/2026 Arrival place: HAN
9 MOS BUI ANH HUNG M 01/08/1987 C9078923 VN 07/05/2030
10 MOS CHU TIEN DAT M 26/07/1982 C9121882 VN 12/05/2030 Disembarking:
11 MOS LE QUANG TUAN M 21/04/1984 C9138647 VN 19/05/2030 Through on
12 MOS NGUYEN MAU THIN M 21/02/1988 K0361001 VN 23/04/2032 same Flight:
13 MOS PHUNG VAN BANG M 10/12/1987 C8188605 VN 17/09/2029
HAN

DECLARATION OF HEALTH FOR OFFICIAL USE ONLY


Name and seat number of function of person on board with illnesses other than airsickness or the effects of accidents,
who may be suffering from a communicable disease (a fever-temperature 38 C/100 F or greater associated with one or
more of the following signs or symptoms,e.g. appearing obviously unwell, persistent coughing, impaired breathing,
persistent diarrhoea, persistent vomitting, skin rash; bruising or bleeding without previous injury; or confusion of recent
onset, increases the likelihood that the person is suffering a communicable disease) as well as such cases of illness
disembarked during a previous stop . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
...............................................................................................
Detail 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, with time and date ---------------------------------------------


Crew member concerned

I declare that all statements and particulars contained in this General Declaration, and in any 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.

SIGNATURE :..........................................
Authorized agent or Pilot-in-Command

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