AIRCRAFT GENERAL DECLARATION

(Outward - Inward)
Agriculture, Customs, Immigration, Public Health

Owner or Operator ExecuJet Aviation Pty Ltd

Nationality and Registration South Africa - ZS-KEN
Flight No. Platinum 006 Leg Type Owner
Departure from BEW / FQBR Arrival at FIH / FZAA
Departure Time 24 JUL 2022 17:00 (LT) Arrival Time 24 JUL 2022 19:45 (LT)

Flight Routing
(Place column always to list origin, every enroute stop and destination)
Place Names of Crew Numbers of Passengers on this stage Cargo
FQBR CAPT: John Henry Mitchell none
FZAA CAPT: Shane Alaister Cade Departure Place: Cargo
Manifests
ISP: Glenn Taylor
Embarking: _______________ attached
OBSERVER: Brian Bennetts
Through on same flight: ___________

Arrival Place:

Through on same flight: ___________

Desembarking: _________

Declaration of Health FOR OFFICAL 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:
none
_____________________________________________________________
Any other condition on board which may lead to spread of disease
none
______________________________________________________________
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:
______________________________________________________________
Signed, if required: ________________________

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 thru passengers will continue/have
continued on the flight.

Signature ____________________________
Pilot in Command
 Passenger Manifest
Owner or Operator ExecuJet Aviation Pty Ltd
Nationality and Registration South Africa - ZS-KEN Flight No. Platinum 006
Departure from BEW / FQBR Arrival at FIH / FZAA
Departure Time 24 JUL 2022 17:00 (LT) Arrival Time 24 JUL 2022 19:45 (LT)

CREW
Name Date of Birth Gender Type Issuing Country Number Issue Date Expiry Date
CAPT: John 05 MAY 1966 Male
Henry Mitchell
CAPT: Shane 31 MAR 1972 Male Passport (PP) South Africa M00334464 30 OCT 2020 29 OCT
Alaister Cade 2030
ISP: Glenn Taylor 06 NOV 1958 Male Passport (PP) South Africa M00145843 23 APR 2015 22 APR 2025
OBSERVER: 03 MAR 1980 Male Passport (PP) South Africa A06689368 23 APR 2018 22 APR 2028
Brian Bennetts

PASSENGERS
Name Date of Birth Gender Type Issuing Place of Birth Number Issue Date Expiry Date
Country
Ms. Kabengele 11 MAR 1962 Passport (PP) Belgium GA6953164 23 JUN 2022 22 JUN 2029
Kapinga
Mr. Nicolas 07 JAN 1966 Male Passport (PP) Congo, DP0009027 06 MAY 2021 05 MAY
Serge Democratic 2026
Kadima-Nzuji Republic
Kazadi
Mr. Joel 12 SEP 1999 Male Passport (PP) Congo, DP0008595 21 JUL 2020 20 JUL 2025
Honore Kazadi Democratic
Republic
Mr. Dieudonne 29 MAY 1977 Male Passport (PP) South Africa A09310521 13 APR 1977 12 APR 2031
Mankasi
Ms. Solange 28 JUL 1966 Passport (PP) Congo, DP0004458 08 JAN 2023
Mikoso Democratic
Kabengele Republic
Mr. Christopher
Ode
Mr. Yannick
Onawelo