Coronavirus (COVID-19): declaration form
for international travel from England during
stay at home restrictions
You must complete this form to confirm that you are outside of your home
to travel abroad for a legally permitted reason. Different rules apply in Northern
Ireland, Scotland and Wales.
This requirement applies to people travelling outside the UK from England. You don’t
need to complete the form to travel to Ireland, the Channel Islands or the Isle of Man if
that is your final destination.
Legally permitted reasons for international travel include:
medical, or compassionate grounds
weddings, funerals and related events
Find out more about the legally permitted reasons.
Some people do not need to complete the form because of the job they do.
You do not need to complete the form yourself if you are under the age of 18 or if you
lack capacity to complete the form. If a responsible adult is travelling with you,
they must complete a separate copy of the form on your behalf.
Print a copy of the completed form or save it to a mobile phone or other device.
You may be required to present this declaration and asked for any evidence to support
your reason for travel at your port of departure.
Keep this form with you police may ask to see it but will not collect it from you.
Declaration for international travel
Details of the traveller
Given name(s):
Date of birth (dd / m m / y y y y):
Home address:
Passport number, or travel document reference number (as appropriate):
I hereby declare that my reason for being outside my home to travel
internationally is for:
Medical, or compassionate reasons
Wedding, funeral or related event
Other permitted reasons please specify:
I certify that the information I have provided is true. I understand that if I provide false or
misleading information, I may be issued with a fixed penalty notice and/or a direction to
return home; or be arrested.
If completing electronically, write your full name.
Write your full name if you are signing the form on behalf of another traveller:
Date (dd/mm/yyyy):