CLEARANCE TO FLY

This certifies the passenger named below is clear to fly to Cyprus.

ADRIANA KONSTANTINOU
Cypriot Identity Card: 0000862957
Evidence of COVID test available

Country Category:
Orange Category

Flight Number: Flight Type:

0B0137 Direct Flight to the Republic of Cyprus

Date: Departing Country:

29-12-2021 07:15 Romania

CyprusFlightPass: CFP3576500

Passenger has not travelled abroad in the last 14 days

Personal Information
Name: Middle Initial: Year of Birth:
ADRIANA KONSTANTINOU 1968

Cypriot Identity Card: Nationality Country: Country of Birth:

0000862957 CYPRUS, REPUBLIC OF ROMANIA

COVID-19 Test: Test Date: Test Type:

Yes 27-12-2021 13:50 RT-PCR

Is Negative: Yes

Flight Information
Airline Name: Flight Number: Seat Number:
BLUE AIR 0B0137

Country of Departure: Departure Date & Time Departure date from Cyprus:
ROMANIA (Country of Origin): 28-12-2021 15:17
29-12-2021 07:15

Contact Details
Mobile: Other Phone: Email:
+35797659661 mariastilioanou@yahoo.com

Permanent Address
Address: Apt Number: City:
KORMAKITI 24 101 NICOSIA

State: Postal code: Country:

NICOSIA 1048 CYPRUS, REPUBLIC OF

Address in Cyprus
Address: Apt Number: City:
KORMAKITI 24 101 NICOSIA

State: Postal code: Hotel:

NICOSIA 1048

Emergency Contact
Name: Country/State:
MARIA STYLIANOU CYPRUS, REPUBLIC OF/POTAMIA

Mobile: Other Phone: Email:

+35799161307

Solemn Declarations
YES I am fully aware of the risks, dangers and hazards connected to my flight and stay in the Republic of Cyprus, due to
the COVID-19 pandemic. I assume and accept full responsibility for any risks of loss, harm, property damage or personal
injury or death and I agree not to make claim and take proceedings against any person and/or any kind of businesses
and/or authorized officers and /or the authorities of the Republic of Cyprus from any loss, liability, damages or costs that I
may sustained and/or costs that I may incurred during my travel and stay to the Republic of Cyprus, as a result to COVID-
19 and/or for any inconvenience I and/or they will be suffered, due to any precautionary measures applied during my trip
and my stay in the Republic of Cyprus, for the purposes of protection of public health against COVID-19. This waiver of
Liability, shall be binding to my family members and spouse and my heirs, assigns and personal representative,
executors and successors.
YES Following my return to my country of permanent residence, or to the country to which I return following the
completion of my trip to the Republic of Cyprus, I shall inform the Medical Services of the Republic of Cyprus in the case I
have developed symptoms of COVID-19, within 14 days following my departure from the Republic of Cyprus (via the
CyprusFlightPass Platform).
YES I have not experienced one of the following symptoms – fever, cough, fatigue, headache, muscle or body aches,
loss of taste or smell, shortness of breath or difficulty in breathing, sore throat, congestion or runny nose within the last 14
days, or I have experienced the above symptoms within the last 14 days but I was tested negative for COVID-19.
YES I declare that, in the event that for emergency reasons, it is deemed necessary immediate additional measures to be
taken regarding the entry of passengers into the Republic of Cyprus, I will fully comply with these measures for the
purposes of my entry into the Republic of Cyprus, by personally paying any costs.
YES I have not been found positive for COVID-19 within the last 11 days or I have been found positive for COVID-19 and
11 days will have at least passed from the date I was tested positive for COVID-19 and my flight date.
YES I consent for possible COVID-19 sample testing, if requested, upon arrival to the Republic of Cyprus (Persons
allowed to enter in the Republic of Cyprus under the Vienna Convention of 1961 and 1963 are exempted).
YES I declare subject to sanctions under the laws of the Republic of Cyprus that the facts and information I have
provided, are complete, correct and true.
YES I have not stayed/lived in countries with less favourable epidemiological criteria (Red Category or Grey (Special
Permission) Category) compared to the country of departure, within the past 14 days before my travel to the Republic of
Cyprus, as per relevant country categorization announcement of the Republic of Cyprus.