Declaration of Honour



I, ………………………………………………………………………………………. (Name, Surname),


Born ……………………………………………… (Date of Birth),


Birth ID number …………………………………….. (Personal Identification Number),


Address………………………………………………………………………………………,



honestly declare,


that I have not visited any location of risk stated at the official website of the Ministry of
Health of the Czech Republic within last 30 days (see also
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6,
http://www.szu.cz/tema/prevence/koronavirus-2019-ncov-aktualni-data), and that I have not been in
contact with anybody who had been ordered a quarantine or who had visible symptoms of the COVID-19
disease.






In Brno on  ……………………………





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                                                                                       Signature