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    Declaration of Travel History of Seafarer (Past 28 Days)

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    Saurabh Rai
    The document is a travel history declaration form for a seafarer over the past 28 days. It collects information such as the seafarer's name, last sign off date and port, passport number, and details of places visited on specific dates including addresses, approximate times, names of people met, and their contact details. The seafarer declares that the information provided is true, correct and complete to the best of their knowledge.

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    Declaration of Travel History of Seafarer (Past 28 Days)

    Uploaded by

    Saurabh Rai
    37 views1 page
    The document is a travel history declaration form for a seafarer over the past 28 days. It collects information such as the seafarer's name, last sign off date and port, passport number, and details of places visited on specific dates including addresses, approximate times, names of people met, and their contact details. The seafarer declares that the information provided is true, correct and complete to the best of their knowledge.

    Original Description:

    Original Title

    Travel History

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    The document is a travel history declaration form for a seafarer over the past 28 days. It collects information such as the seafarer's name, last sign off date and port, passport number, and details of places visited on specific dates including addresses, approximate times, names of people met, and their contact details. The seafarer declares that the information provided is true, correct and complete to the best of their knowledge.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xlsx, pdf, or txt
    37 views1 page

    Declaration of Travel History of Seafarer (Past 28 Days)

    Uploaded by

    Saurabh Rai
    The document is a travel history declaration form for a seafarer over the past 28 days. It collects information such as the seafarer's name, last sign off date and port, passport number, and details of places visited on specific dates including addresses, approximate times, names of people met, and their contact details. The seafarer declares that the information provided is true, correct and complete to the best of their knowledge.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xlsx, pdf, or txt
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    Declaration of Travel History of seafarer (past 28 days) Annexure - I

    Name
    Last sign off Date Indos No.
    Last sign off Port/ Country Pasport No.

    Details / address of place visited (Home, Friend, Hotel, Social gathering, Approx. time of visit to Name of the person(s) you met Contact details (phone no.)
    S. No. Date Hospitals etc.) place(s) Hrs with of person(s) met

    I / we, do hereby declare that above particulars of information and facts stated are true, correct and complete to the best of my knowledge and belief.

    Place:
    Date: Name / Sign.

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