IDENTITY aos poe ental Vio Unt, BMALTA VateyRooa Muda, MSO 9020, MALTA +356 2590 4550, E visima@gow mt Declaration form in relation to quarantine rules Personal Data 1. name MICfhEL JOHN 2. sumame_ YAN CH 3, Date of Birth OS] 04 1994 4. wationatty TAVIPI NO. s.rauponnunber PAHGO%G3A I, the undersigned, hereby declors that ! am aware ofthe quarantine rules for non-vaccinated persons or perso sot recognised by Malta. | am alsa aware that currently there is 3 mini 1 Euro for mandatory quarantine in such cases. | am responsible for yal {21 ol the correct information before proceeding with travel to Mata, Date 20)04| 2034) ‘The personal data requested is being processed according tothe General Data Protection Regulation (EU) 2016/679 and the Data Protection Act 2018.