C.
EXCEPTIONS:
Child 2 to 17 years of age OR Participant in certain COVID-19 vaccine trials as determined by CDC
I attest that I am (or the person I am attesting on behalf of is)
excepted
from the requirement to present
Proof of Being
Fully Vaccinated Against COVID-19
and made the following arrangements
(must check all boxes in D and then sign
Attestation)
.
To be tested with a COVID-19 viral test 3-5 days after arriving in the United States, unless I have (or the person
has) documentation of having recovered from COVID-19 in the past 90 days;
To self-isolate for a full 5 calendar days and properly wear a well-fitting mask any time I am (or this person is)
around others during my (or this person’s) isolation period and for an additional 5 days after ending isolation,
- if the result of the post-arrival viral test is positive; or
- if I develop (or this person develops) COVID-19 symptoms.
D.
EXCEPTION: Diplomat and Official Foreign Government Travel
See Alaska Airlines Agent for expanded attestation
E.
EXCEPTION: Medical contraindication to an accepted COVID-19 vaccine as determined by CDC
See Alaska Airlines Agent for expanded attestation
F.
EXCEPTIONS:
Humanitarian or emergency exception as determined by CDC; Valid nonimmigrant visa holder (excluding B-1 or B-2 visas) and
citizen of a Foreign Country with Limited COVID-19 Vaccine Availability as determined by CDC; OR Sea crew member traveling pursuant to a
C-1 and D nonimmigrant visa
See Alaska Airlines Agent for expanded attestation
G.
EXCEPTIONS: Person whose entry is in the U.S. National Interest
See Alaska Airlines Agent for expanded attestation
Privacy Act Statement for Travelers Relating to the Requirement to Provide Proof of a Negative COVID-19 Test Result
The United States Centers for Disease Control and Prevention (CDC) requires airlines and other aircraft operators to collect this information pursuant to 42 C.F.R., 71.20 and
71.31(b), as authorized by 42 U.S.C. § 264. Providing this information is mandatory for all passengers arriving by aircraft into the United States. Failure to provide this information
may prevent you from boarding the plane. Additionally, passengers will be required to attest to providing complete and accurate information, and failure to do so may lead to
other consequences, including criminal penalties. CDC will use this information to help prevent the introduction, transmission, and spread of communicable diseases by performing
contact tracing investigations and notifying exposed individuals and public health authorities; and for health education, treatment, prophylaxis, or other appropriate public health
interventions, including the implementation of travel restrictions.
The Privacy Act of 1974, 5 U.S.C. § 552a, governs the collection and use of this information. The information maintained by CDC will be covered by CDC’s System of Records No.
09-20-0171, Quarantine- and Traveler-Related Activities, Including Records for Contact Tracing Investigation and Notification under 42 C.F.R. Parts 70 and 71. See 72 Fed. Reg.
70867 (Dec. 13, 2007), as amended by 76 Fed. Reg. 4485 (Jan. 25, 2011) and 83 Fed. Reg. 6591 (Feb. 14, 2018). CDC will only disclose information from the system outside the CDC
and the U.S. Department of Health and Human Services as the Privacy Act permits, including in accordance with the routine uses published for this system in the Federal Register,
and as authorized by law. Such lawful purposes may include, but are not limited to, sharing identifiable information with state and local public health departments, and other
cooperating authorities. CDC and cooperating authorities will retain, use, delete, or otherwise destroy the designated information in accordance with federal law and the System
of
Records
Notice
(SORN)
set
forth
above.
You
m
ay
contact
the
system
manager
at
dgm
[email protected] or
by
mailing
Policy
Office, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS H16-4, Atlanta, GA 30329, if you have questions about CDC’s use of your data.
3 Any passenger who is not a U.S. citizen, U.S. national, lawful permanent resident, or an immigrant is referred to as a Covered Individual because they are covered by the
Presidential Proclamation and CDC’s Amended Order: Implementing Presidential Proclamation on Advancing the Safe Resumption of Global Travel During the COVID-19 Pandemic.
This term does not apply to crewmembers of airlines or other aircraft operators if such crewmembers and operators adhere to all industry standard protocols for the prevention
of COVID-19, as set forth in relevant guidance for crewmember health issued by the CDC or by the FAA in coordination with the CDC.
_______________________________________________________________________________________________________________________________________________
Public reporting burden of this collection of information is estimated to average 2 hours per response, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to
respond to, a collection of information unless it displays a currently valid OMB Control Number. Comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, may be submitted to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333;
ATTN: PRA 0920-1318.