AG1 - General Declaration (Outward/Inward)
A link to the Portable Document Format (PDF) of this form is provided below. The content of the form is duplicated in HTML following the PDF link.
- Operator
- Marks of nationality and registration
- Flight No.
- Date
- Departure from (place)
- Arrival at (place)
- Flight routing ("place" column always to list origin, every en-route stop, and destination)
- Place
- Total number of crew (To be completed only when required by the State.)
- Number of passengers on this stage (Not to be completed when passenger manifests are presented and to be completed only when required by the State.)
- Departure place
- Embarking
- Through on same flight
- Arrival place
- Disembarking
- Through on same flight
- Departure place
- Declaration of health (To be completed only when required by the State.)
- Persons on board with illnesses other than airsickness or the effects of accidents (including persons with symptoms or signs of illness such as rash, fever, chills, diarrhoea) as well as those cases of illness disembarked during the flight.
- Any other conditions on board which may lead to the spread of disease.
- 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 or most recent disinsecting.
- Signed, if required (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)
- Date modified: