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TRAVEL CERTIFICATE TO FROM THE

This travel certificate is to be presented to the company before use of the travel ticket by travellers intending to travel to France, as as to control authorities. In the absence of this certificate, boarding will be denied or entry to the will be refused. Travellers must also present a sworn statement that they do not show any COVID-19 symptoms. For travellers aged 11 or over coming from the United Kingdom, the valid negative result of a (RT-PCR or lateral flow antigen) or examination carried out no than 72 hours earlier must be shown before boarding. The only antigen tests which be presented are those allowing for detection of the N protein of SARS-CoV- 2.

This travel certificate applies without prejudice to specific access rules that may apply to entry to French overseas collectivities.

To be completed by :

I, the undersigned,

Ms/Mr:

Born on:

Nationality:

Address: certify that my reasons for travel one of the following (tick the box):

[ ] French nationals, and/or their spouse (married, PACS, non-marital union proven by supporting documents) and .

[ ] nationals or nationals from , , , , , , , the United Kingdom or the Vatican, whose primary residence is in France or who are in transit through France to reach the country of which they are a national or which is their primary residence, and/or their spouse (married, , non-marital union proven by supporting documents) and children.

[ ] citizens intending to establish their main residence in France before 31 2020, so as to fall under the provisions of the withdrawal agreement, subject to examination of the individual application by the Interior Ministry (DGEF/DIMM/SDV) and the Ministry for and Foreign Affairs (diplomatic and consular posts) ;

[ ] British citizens intending to establish their main residence in a Member State of the European Union other than France before 31 December2020, so as to fall under the provisions of the withdrawal agreement, upon demand of the authorities of the future country of residence and subject to the examination of their individual application by the aforementioned French authorities;

[ ] Third-country nationals holding a valid French or European residence permit or long-stay visa, whose main residence is in France or who are travelling via France to their main residence in a European Union or associated country; [ ] Third-country nationals spending less than 24 hours in international transit areas;

[ ] Holders of an official ;

[ ] Foreign nationals (including UK nationals) employed by diplomatic or consular bodies or international organisations whose or offices are located in France, and their spouses and children,

[ ] UK civil servants carrying out their professional duties, border personnel, customs personnel;

[ ] Foreign (including UK) healthcare workers contributing to the fight against COVID-19 or recruited as interns to assist;

[ ] Transport workers or transport service providers, including drivers or pilots of any freight or cargo vehicles, whether France is their final destination or not, or travelling as passengers to their starting point;

[ ] Drivers or crew members of passenger coaches or trains;

[ ] Personnel of the Channel (inter alia for duties linked to operations, maintenance or ) or of trans-Channel infrastructure;

[ ] Crew members or personnel working on a merchant (including cruise) or fishing ;

[ ] holding long-stay visas, -stay visas for studies or (except short-stay examination visas) or coming for fewer than 90 days from exempt from the short- stay visa requirement, or school-age minors with proof of accommodation in France;

[ ] or researchers employed or invited by a French educational institution or research laboratory, travelling for teaching or research purposes ;

[ ] Third-country nationals with long-stay “passeport talent” visas or intra-corporate transfer visas, and/or their spouse and children;

[ ] Foreign (including UK) nationals coming to France for medical care in a public or private ;

[ ] Foreign (including UK) nationals coming to France to exercise custody recognised by a court decision;

[ ] Third-country nationals working in the humanitarian sector or as an international volunteer ;

[ ] Cross-border workers and posted workers ;

[ ] UK pupils, students and interns who commute to France daily;

[ ] Seasonal workers;

[ ] Journalists carrying out their duties.

Signed in ...... , on...... /...... /2021 (signature)