(Kindly fill out all the information needed and do not leave any box unmarked.
Passengers are required to complete a Health Declaration Form.)
* - Required to fill-up.
2.1 Permanent Address
2.2 Current Address
I hereby authorized the City Government of Davao, to collect and process the above
the purpose of effecting control of the COVID-19 infection. I understand that my personal
is protected by RA 10173, Data Privacy Act of 2012 and that I am required by RA 11449,
Heal as One Act, to provide TRUTHFUL information.