COVID – 19 Declaration Form

The following guidance from government and international health agencies and closely monitoring the current outbreak of pneumonia caused by the Novel Coronavirus (COVID-19). This declaration form satisfies the latest TSA Security Directive requirements.

In an effort to provide charter customers, aircraft owners and crew members with a safe environment, we have implemented protocols on our aircraft to support the global efforts to contain the COVID-19 outbreak.

As part of this protocol passengers are required to fill in the following statement as a prerequisite to boarding aircraft.

Passengers filling out this form, can take solace in procedures that ensures passengers prior to their embarkation on an aircraft have gone through the same screening process along with our Post and Pre-Flight Sanitizing procedures.

The undersigned (Passenger name):

______

US Identity Document / Number:

______

Hereby declares that he/she has not travelled to/through/from China, Iran or a local outbreak area in Italy, South Korea or the Schengen Area (see list below) in the 14 days preceding their departure.

Date: ______

Signature: ______

Print Name: ______

Outbreak Areas China All Regions Iran All Regions Italy – Lombardy Region Codogno, Castiglione d’Adda, Casalpusterlengo, Fombio, Maleo, Somaglia, Bertonico, Terranova dei Passerini, Castelgerundo and San Fiorano Italy – Veneto Region Vo’ Euganeo South Korea Daegu Cheongdo Schengen Area Following countries Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, and Switzerland