solemnly swear




I ………………………………………………………… born on………………………….  hereby solemnly swear that I did not leave the Czech
Republic within 14 days prior to ………………….. (the date of the exam), that I am not obligated to be
kept in quarantine, I am not aware of any change in my state of health that will not allow me to
attend the state exam and that I will not leave the Czech Republic till the given state exam and I
am not aware that I have been in touch with people infected by a coronavirus.




Date: ………………………….


Signature: ……………………………………….