GENERAL DECLARATION

(OUTWARD/INWARD)

AGRICULTURE, CUSTOMS, IMMIGRATION AND PUBLIC HEALTH

Owner of Operator: SPIRIT AIRLINES INC.

Marks of Nationality
And Registration: N934NK Flight No.: NK3122 Date: 05 Feb, 2022

Departure from: Barranquilla, Colombia Arrival at: Miami, Fl

FLIGHT ROUTING
(“Place” Column to list origin, every en-route stop and destination)

PLACE TOTAL NUMBER OF CREW NUMBER OF PASSENGERS THIS STAGE CARGO

BAQ CA - STEFFEN SCOTT

DEPARTURE PLACE
FO - HUGO NICHOLAS BAQ

FA - APPLING LAUREN ASHLEY Embarking:

0
FA - CULVER CHANTE Through on Cargo
same flight: Manifest
FA - VIECELLI TAMMY Attached
ARRIVAL PLACE
FA - WILLIAMS JAMAEL
MIA
Disembarking: 0
Through on COMAIL
same flight: Envelope

DECLARATION
MIA OF HEALTH
Name and seat number or function of persons on board with illness other than For official use only
airsickness or the effect of accidents, who may be suffering from a communicable
disease (a fever-temperature of 38ºC/100F or greater associated with one or more
of the following symptoms,e.g. appearing obviously unwell: persistent coughing,
impaired breathing, persistent diarrhea or vomiting, skin rash, bruising or bleeding
without previous injury, or confusion of recent onset, increases the likelihood that ETD:
the person is suffering a communicable disease) as well as such cases of illness
disembarked during a previous stop. 10:50
PAX:

Any other condition on board which may lead to the spread of disease:
None CREW:
6
Details of each disinfecting or sanitary treatment (place, date, time, method) during
None ATD:
the flight. If no disinfecting has been carried out during the flight, give details of
most recent disinfecting:
T0TAL PAX:

Signed,
None if required:
CREW MEMBER CONCERNED

I declare that all statements and particulars contained in this general declaration and any supplementary forms required to be present with this General Declaration are
complete, exact and true to the best of my knowledge and that that all passengers will continue/have continued on the flight.

SIGNATURE:

Rev. 08.18 AUTHORIZED AGENT OR PILOT IN COMMAND