SWORN STATEMENT - Minister of the Interior
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EXEMPTION CERTIFICATE FOR TRAVELTO AND FROM THE OVERSEAS TERRITORIES THAT REQUIRE COMPELLING REASONSWHICH ARE PERSONAL OR FAMILY-RELATED, DUE TO A HEALTH EMERGENCY OR A PROFESSIONAL PURPOSE THAT CANNOT BE POSTPONEDPassengers shall present this certificate to transport companies before using their ticket, as well as to the authorities. Failure to do so, the passenger shall be denied boarding or access to the territory. Additionally, the following must be provided:A sworn statement of absence of COVID-19 symptoms and absence of contact with a confirmed case of COVID-19;For persons aged 11 years or more, a virology screening test (PCR) carried out less than 72 hours before boarding, showing no COVID-19 contamination;A sworn statement committing to seven-day self-isolation and to undergo a virology screening test (PCR) at the end of the isolation period.To be completed by the passenger:I, the undersigned,Mr/Mrs:?...Born on:Nationality:Residing at:Hereby certify that my reason for travelling is one of the following set out in paragraph II, Article 4 of Decree No. 2020-1310 of 29 October 2020 (tick the appropriate box):[ ] Compelling personal or family-related reason (specify): [ ] Health-related and considered as an emergency (specify): [ ] Professional purpose that cannot be postponed (specify): Address of self-isolation place:Done in ................................., on......../......../2021(signature)SWORN STATEMENTTO ABIDE BY THE RULES FOR ENTRY INTO THE NATIONAL TERRITORY(METROPOLITAN OR OVERSEAS TERRITORY)Passengers wishing to travel to metropolitan France shall present this statement to transport companies before using their ticket, as well as to the border control authorities.I, the undersigned,Mr/Mrs:?...Born on:At: Residing at:Hereby declare on my honour that during the last 48 hours I have not had any of the following symptoms:Fever or chills;Cough or aggravation of my usual cough;Unusual fatigue;Unusual shortness of breath when I speak or make the slightest effort;muscle pain and/or unusual aches and pains;Unexpected headaches;Loss of taste or smell;Unusual diarrhoea.Hereby declare on my honour that I have no knowledge of having been in contact with a confirmed case of COVID-19;Hereby pledge on my honour to:Undergo an antigenic test or any screening upon arrival;Self-isolate for seven days;Undergo a virology screening test upon completion of the seven-day isolation period.Done in:On: at hSignature: ................
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