GENERAL DECLARATION REFERENCE NO:

I.C.A.O ANNEX 9 APPENDIX 1

AMM1434GD
(OUTWARD/INWARD)

OWNER OR OPERATOR: SAUDIA

MARKS OF NATIONALITY AND REGISTRATION: HZAS60 FLIGHT: SV0636 DATE: 21MAY2024
DEPARTURE FROM: AMM - JORDAN ARRIVAL AT: JED - SAUDI ARABIA

RANK STATUS CREW ID CREW NAME SEX DATE OF BIRTH NATIONALITY PASSPORT NO PASSPORT EXPIRY
CA FLY 11010068 ALNASSAR ABDULLAH M 08SEP1987 SA U622351 29APR2027
SO FLY 30002826 ALROQY KHALED M 09JAN1999 SA ZX60061 08JUL2027
GD FLY 11007812 GUDSI ABDULLAH M 29NOV1986 SA U101792 13JAN2027
SNF FLY 11020462 ALSHEHRI AHMAD MOHAMMED AHMAD M 25MAY1989 SA ZX55619 23AUG2027
PC FLY 11011117 ACHIBANE HAJAR F 07OCT1989 MA NB8754580 24NOV2026
YC FLY 11013937 KHAN SAMREEN F 05JAN1989 IN Z2888981 20JUL2029
YC FLY 11022419 SAMMAN MAHER AHMEDFOAD M M 01MAR1989 SA X773846 26MAY2029

DECLARATION OF HEALTH FOR OFFICIAL USE ONLY

NAME AND SEAT NUMBER OR FUNCTION OF PERSONS ON BOARD WITH ILLNESSES OTHER THAN AIRSICKNESS OR
THE EFFECTS OF ACCIDENTS, WHO MAY BE SUFFERING FROM A COMMUNICABLE DISEASE (A FEVER-
TEMPERATURE 38C/100F OR GREATER-ASSOCIATED WITH ONE OR MORE OF THE FOLLOWING SIGNS OR
SYMPTOMS, E.G. APPEARING OBVIOUSLY UNWELL: PERSISTENT COUGHING: IMPAIRED BREATHING: PERSISTENT
DIARRHOEA: PERSISTENT VOMITING: SKINS RASH: BRUISING OR BLEEDING WITHOUT PREVIOUS INJURY: OR
CONFUSION OF RECENT ONSET, INCREASES THE LIKELIHOOD THAT THE PERSON IS SUFFERING A COMMUNICABLE
DISEASE) AS WELL AS SUCH CASES OF ILLNESS DISEMBARKED DURING A PREVIOUS STOP

DETAILS OF EACH DISINFECTING OR SANITARY TREATMENT (PLACE, DATE, TIME, METHOD) DURING THE FLIGHT. IF
NO DISINFECTING HAS BEEN CARRIED OUT DURING THE FLIGHT GIVE DETAILS OF MOST RECENT DISINFECTING

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.

BY 11021334 @21MAY2024 14:23 UTC SIGNATURE

AUTHORIZED AGENT OR PILOT-IN-COMMAND