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: VN5590 Date: 16JUN2022
Departure from: HAN Arrival at: CAN
(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
HAN 1 CAPT NGUYEN THANH TUNG M 05/03/1976 C9384587 VN 12/10/2030 Departure Place: HAN
2 FO NGUYEN HOANG VIET M 06/01/1992 C6787598 VN 25/02/2029
3 POS LE VIET TOAN M 16/12/1986 C7455259 VN 31/05/2029 Embarking:
4 POS NGUYEN THI THUY LIEN F 30/10/1990 C9654947 VN 29/03/2031 Through on
5 POS LUU HONG NHUNG F 12/02/1987 C8595897 VN 04/12/2029 same Flight:
6 FE PHUNG LE HOANG M 16/08/1989 C6676778 VN 28/01/2029
7 MOS DINH TUAN TU M 17/02/1999 K0244787 VN 13/04/2032
8 MOS LE VAN VIET M 24/12/1994 C9131383 VN 05/06/2030 Arrival place: CAN
9 MOS DAM KHAC DUNG M 01/06/1983 C6117706 VN 18/09/2028
10 MOS NGUYEN THIET NHU M 02/03/1992 K0317969 VN 18/04/2032 Disembarking:
11 MOS PHAM DUC HIEU M 23/06/1973 C8999517 VN 25/05/2030 Through on
12 MOS TRAN TRUNG KIEN M 18/08/1989 C9176204 VN 02/07/2030 same Flight:
13 MOS TRAN TUAN VIET M 29/08/1988 C3848426 VN 01/09/2027
CAN

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