General Declaration

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..................                                      (Place and Country)                         &....

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....itary treatment (place, date, time, method) during the flight. If no disinserting has been carried out during the flight, give details of most recent disinsecting ...................... Sgd., if required _______________ Crew member concerned   I declare that all statements and particulars contained in this General Declaration, and in any supplementary form required to be presented....