Respuesta Oficio

DIRECCIN GENERAL DE AERONUTICA CIVIL
DEPARTAMENTO JURDICO
D.G.A.C. Of. N Q5/0/
fr\ I
2 9 9 5/
OBJ.: Complementa informacin sobre

operaciones
de
aeronave
Cessna 525, Matrcula PR-TAP.
REF.: 1) Oficio N 05/0/408/2598, de 9
de mayo de 2016, de D.G.A.C.
2) Oficio N 17.715, de 23 de
marzo de 2016, de Prosecretario
de la Cmara de Diputados.
SANTIAGO,
DE
PARA
2 4 MAYO 2016
:
DIRECCIN GENERAL DE AERONUTICA CIVIL

H. CMARA DE DIPUTADOS
Mediante oficio de la referencia 1) esta Direccin General

evacu respuesta al tenor de solicitud que le formulara la Diputada seora
PAULINA NEZ URRUTIA y los Diputados seores JOS MANUEL
EDWARDS SILVA, GONZALO FUENZALIDA FIGUEROA y FELIPE WARD
EDWARDS, quienes en uso de las facultades conferidas por el artculo 9 de
la Ley N 18.918, orgnica constitucional del Congreso Nacional, nos
recabaron antecedentes respecto de la operacin en Chile de la aeronave
Cessna 525, matrcula PR-TAP, procedente de Brasil.
Sobre el particular y en cumplimiento del compromiso

asumido en el ltimo prrafo de nuestra comunicacin anterior, venimos en
complementar la documentacin inicialmente proporcionada, con el envo de
los manifiestos de pasajeros que se logr recopilar, generados con ocasin de
los despegues efectuados por la aeronave singularizada en la suma desde los
terminales nacionales que en cada caso se indica en el perodo comprendido
entre junio y diciembre de 2013, datos que estamos ciertos debieran satisfacer
el requerimiento que esa institucin nos planteara en ejercicio de la funcin
fiscalizadora que el ordenamiento legal le asigna.
Sin perjuicio de lo anterior, y como es sabido, en la
materia que nos ocupa existe actualmente en pleno desarrollo una
investigacin a cargo del Ministerio Pblico, en cuyo contexto nuestro
organismo ha debido proporcionar a la Polica de Investigaciones (PDI)
DGAC - Clasificador 3 "Correo 9^ Providencia - Santiago - Fono 224392000 rFax 224368143
OIRS www.dgac.gob.cl
anloga informacin a la demandada por esa H. Cmara, actuaciones que

tienen el carcter de secretas para ios terceros ajenos al procedimiento,
obligacin impuesta por el artculo 182 del Cdigo Procesal Penal, texto
aprobado por la Ley N 19.696, situacin que se advierte al tenor de lo
solicitado en el oficio de la referencia 2).
Saluda atentamente,
VILLALOBOS COLLAO
I de Brigada Area (A)
ECTOR GENERAL
DISTRIBUCIN:
1.- H. Camarade Diputados *

2.- DGAC, Departamento Secretara General, Oficina Central de Partes (I)
3.- DGAC, Departamento Jurdico (A)
VVC/PRM/FPM
OPERACIONES MATRCULA PRTAP AP.CHACALLUTA - ARICA

A
Fecha
1 15-09-2013
Acti
Aer
XX
Vuelo
Reg
N
N
Matricula
PRTAP
A/D
20:40
R/l
Plataf
20:35
Fecha R / l
Dest.
SCEL
Aerova
23
Lz
Is
N
S
2 27-09-2013
Q2
PRTAP
20:30
20:25
SCDA
20
3 13-10-2013
Q2
PRTAP
22:34
22:29
SCEL
23
4 09-11-2013
02
PRTAP
00:21
00:16
SCDA
20
AIR D1SPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOMS, IMMIGRATIONS, AND PUBLIC HEATH
Owner or Operator TAXI AEREO PIRACICABA LTDA
Marks of C-525
NalionaWy and Registrations PR-TAP - BRASIL
Dato
Uepnittirefrom
ARICA - CHILE
Arnvil nt
TOTAL NUMBER OF CRfEW
l |
RICARDO COSTA FERREIRA
FF568207
RODRIGO RODRGUEZ
CY274217
15 SEPTIEMBRE 2013
SANTIAGO - CHILE
NUMBER OF PASSENGERS PASSPORT N"
MARCO ENRIQUE^ O. - 13.436.389-4

FELIPE PIZARRO C. --16.163.532 4
HERNN ROSAS R. - 8.574.245-0
SEBASTIAN GONZLEZ - 13.912.629-7
MATAS BERNALES - 17.441.145-K
FLIGHTROUTING PLACE
JAIME PARADA -13.272.974-3

P E CI.AR ATtQNJifL ! ' CAL7M
Persons oii boanl knawn lo be suffntuj from i'inos-;
ausicknnS nr (he elfer.ls o acniipnis as wH is '.'^-^.
liliiflSft lisnuibirktid iluring thc' (light
FOT Official USO OMly
NONL
Auy olhfr condilion on honrd wich nui^ Inart tu '':c
f.)Otfllfs
of
C0ct>
lISiilSt'CtlMU
f. ( )ni|'Jfy
li'Ml'Mt.Tl
lllni;t;.(]^lt'.(ime.Hie!U)d) dunnq llv; flirjhl if no 'Jcsirisf.'<.1.piu

luis Unen caifiti) out ti; (liu'ii ijiuf1 deliMs f tnom mo-n
Stgned, if requerid
Ciew Mm
I declarcd that afl staments and partculars

contained in this General Doclaration. Agent
ot Pilot in Comand in any supplementary
forms required to be presentcd with this
General Declarationare complete, exact true
to the best of only my knowledge and that
all through passengors wN continue/havc
contnued on (fio flight.
] ;
SIGNAKll^ ADJMCf-s'l/L
|i
i
:
!|
AIR DISPATCH CHILE

GENERAL DECLARATION
(Oufward/lnward)
Owncr or Operator
TAXI AEREO PIRACICABA LTDA
Maiksof C-525
Nationality and Registrations PR-TAP - BRASIL
Departure from
ARICA - CHILE
Arnvalat
TOTAL NUMBER OF CREW
FF568207
RODRIGO RODRGUEZ
CY274217
Date
27 SEPTIEMBRE 2013
IQUIQUE - CHILE
1
CRISTIAN WARNER - 12,869.443.-9
MARISELA SANTIBANEZ - 12.880,575-3
ROBERTO MASSOT -5.912.475-7
FLIGHT ROUTING PLACE
LCLAKATIONOr HEALTH
Pcrsons or boift known lo l sulltfrmy hum itHn.'ss orMcr m<m
airsicknfss or tlie effecis of attidenls. as weH as thoip fti<5/"i of
illness disornl)rked iuring ihn (lighl
.,,-,.,,
For OffCal US o
-
Any olhfii c.oii(}itif>ri fin hoanl vi<:h ni.ty \t-mi te. tho
ilisiMsi?
NON!
(place (l.iie.lim! melhod) dirrtng the Hi^tti II no tpitnspclun]

luis DRRM curnetl oul trie tlicjhl givP lirMaNs o' mo!,i ((jct'l
A YLD
Signed, if requerid
i'.nnrfr,>,. ( j
I declared that al) staments and particulars

contained in this General Dcclaration, Agcnt
ot Pilot in Comand in any suppletnentary
! forms required to be presentod with this
to the bost of only my knowledge and that
a U through paasengers wilt continuc/havc
contnucd on the ffight.
SIGNAIUKI AUTHORI/t-n
AIR D1SPATCH CHILb
^^_^__^_.
''
^^^^^^^-
GENERAL DECLARARON
(Outward/lnwardj
RICULTURE, CUSTOMS, IMMIGRATIONS, AND PUBLIC HEATH
Owner or Operalor TAXI AEREO PIRACICABA LTDA
Morks uf C-525
Date
Departure from
ARICA
Arnva at
- CHILE

RICARDO COSTA FERREtRA
FF56B207
RODRIGO RODRGUEZ
CY274217
3 OCI. 2013
13
OCTUBRE
SANTIAGO - CHILE
N U M B E R OF PASSENGERS PASSPOHT
^=-=.
--.^
KAREN DOGGENWEILLER - 10.354.902-7

PEDRO GARCA - 15.170.594-4
EVELYN TAPIA - 15.514.537-4
MANUELA GUMUCIO
DECLARARON QF HEALTH
i'ostms nn bnard knywn lo he sullrrtng ftom illoess nihrr itvi"
)inf,.hn(!s i>r thp oflecls of ledenla is wcll ;>s itiosf i..<sw u'
ilin,?ss ttist'mli.Tknil (lunng IHe Hujtil
.,-->.
For official uso only
Any ottior cardiMm oi Iwnrti wch 'iviv ^-nJ I" Iho sprp,,irJ n'
iseasfl
WOA/fc
o eati desmsi'cti'H) o< sflmtafy iif^Mic

(plir.o (Islc.ltnie.mr-thnd) dvinnii l'ie fltyhi l! no Jes'ns^r.tm
ha*, iwen r.arned oul Ihfi fltQtn ()'ve flotiiHr. of nosi rprc
Signed. if requerid
Orw
\ declarad that all staments and particulars 1 SIONAUJKC AUTHOHIZ o
contained jn this General Declaration, Agcnt

ot Pilot in Comand in any supplemontary
forms requtred to be presented with this
Goncral Declarationare completo, cxact true
to the best of only my knowledgo and that
all through passengers will continuo/have
continued on the flight.
2013
|i
AIR DISPATCH CHILE

GENERAL DECLARATION
(Ouward/lnward)
Owner or Operator TAXI AEREO PIRACICABA LTDA
Marks of C-525
Nationallty and Rcgistrations PR-TAP-BRASIL
Date
Departuro from .
ARICA - CHILE
Arnvalat:
08 NOVIEMBRE 2013
IQUIQUE - CHILE
NUMBER OF PASSENGERS PASSPORT
RICARDO COSTA FERREIRA FF568207

RODRIGO RODRGUEZ
MARCO ENRIQUEZ O. - 13.436.389-4

HERNN ROSAS R. - 8.574.24S-0
CRISTIAN WARNER - 12.869.44.1-9
CY274217
FELIPE PIZARRO - 16.163.532-4
MARCOS ORTIZ - 10.079.303-2

CECILE TRON MURATORI - 23.386.516-fl
DECIARATKIN OF HEALTH
P creos on board known to bfi suffpnny (rom tUn^ss otru-i Hmn
antticknes or Ihc ofreca of occnlonls. fls we<l as trios; casws of
iflnnsR d*mhntk*cl cluimfl th flight
A,n/UrAny othef condrtion on (xjard wich may (eod lo thn
For offtcial uso only
<.tf
o "ocfi 3psiseciri o<

lp<ac,datH.linie,mtliyO) dunng Ifie fltyhl if no deinsc(ing
hM twi cirrled oiit Wie flight yiv> detalla of mtiRl rece
Signed, if requerid
ifiw rvfcmlWr 1-orn
I de el a red that all staments and parliculars

contalnod in tlis General Declaraton, Agent
ot Pilot in Comand In any supplementary
forms requirtd to be prosented with ths
General Declarationare complete, exact truo
all ihrough passengers will continue/navo
continuod on the flight.
SIGNATUREAUTHORIZtO
OPERACIONES MATRICULA PRTAP AP. DIEGO ARACENA - IQUIQUE

Fecha
15-09-2013
27-09-2013
09-11-2013
Acti
Aer
Vuelo
Reg
Matricula
A' D
R/l
Platar
Fecha R / l
Dest,
XX
PRTAP
01.06
OC58
SCAR
02
PRTAP
21:33
21:28
Q2
PRTAP
1906
1900
Aerova
Is
21
SCEL
20
SCEL
20
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOMS, IMMIGRATIONS, AND PUÎC HEATH
Owner or Operator : TAXI AEREO PIRACICABA LTDA.
Marks of C-525
Nationality and Registrations PR-TAP-BRASIL
Date: 14 SEPTIEMBRE 2013
Departurefrom : IQUIQUE - CHILE
FF568207
RODRIGO RODRGUEZ
CY274217
PECLARATION OF HEALTH
Persons on board known lo be suffering from illness other than
araickness or tho effecls of accidenta, as well as those cases of
lineas disembarkedduring thefligh!; .,.,,_
A/O/VE
Arrival at: ARICA - CHILE

NUMBER OF PASSENGERS PASSPORT N
MARCO ENRIQUEZ O. -13.436.389-4

FELIPE PIZARRO C. - 16.163.532-4
HERNN ROSAS R. - 8.574.245-0
CRISTIAN JAMETT - 13.237.896-7
Por otficial use only
Any olher condilion on board wich may lead to the spread of

disease:
NONE
Detalla o each desinsecting of sailary Ireatment
(place,date,time.melhod) during the tlighl. lf no desinsecting
has been canied out the flight give detalls of most recent
desinsecling:
SPRAYED
Signed, if requerid.
Crew Member Concemed
1 declarad that all staments and particulars

contained in this General Declaration, Agent
ot Plot in Comand in any supplementary
forms required to be presentad with this
all through passengers will contlnue/have
SIGNATURE AUTHOR1ZED
2 7 SFI 013
AIR DISPATCH CHILE
GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOMS, IMWHGRATIONS, AND PUBLIC HEATH
Marksof C-525
Date: 27 SEPTIEMBRE
Departure from :
IQUIQUE - CHILE
2013
Arrival at : SANTIAGO - CHILE
FF56B207
RODRIGO RODRGUEZ
CY274217
ACFT SIN PAX
DECLARATION OF HEALTH
Persons on board known to be suffering from illness olher than
airsickness or ihe effecls of accidente, as well as Ihoss cases of
illness disembarked dunng the (hght: ....^
For official use only
Any olher condition on board wich may lead lo the spread of

disease.
NONE
Delalls of each desmsecting or sanitary treatment
(place. date. time. rnethod) during the flight. If no desmsecling
has been carned out the llight give detalls of rnosl recent
desinsecting.
SPRAYED
Signed. if requerid
. .
Crew Member Concerned
I declared that all staments and particulars

contaned in this General Declaration, Agent
forms required to be presentad wth this
all through passengers will continue/have
contnued on the flight.
SIGNATURE AUTHORIZEp-.-
;'
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Owner or Operator ; TAXI AEREO PIRACICABA LTDA.
Marks of C-525
Date: 09 NOVIEMBRE 2013
Departure from :
IQUIQUE -/CHILE

ACARDO COSTA FERREIRA
RODRIGO RODRGUEZ
Arrival a t :
SANTIAGO /CHILE
NUMBER OF PASSENGERS PASSPORT N'
FF568207
CY274217
Persons on board known to be suffering from illness other than
airsickness or the effects of accidents, as well as those cases of
illness disembarked during theflight: .,.,,_.
NONE

HERNN ROSAS R. - 8.574.245-0 (
CRISTIAN WARNER - 12.869.443-9 /
/
MARCOS ORTIZ -10.079.303-2
CECILE TRON MURATORI - 23.386.516-8''
Any other condition on board wich may lead to the spread of

disease;
NONE
Kjetalls of each desinsecting or sanitary treatment
,place,date.time,method) during the flight. If no desinsecting
has been carried out the flight give detalls of most recent
desinsecting:
SPRAYED

forms required to be presented with this
SIGNATURE AUTHORIZED
OPERACIONES MATRICULA PRTAP AP. CERRO MORENO - ANTOFAGASTA

Fecha
Acti
Aer
Vuelo
Reg
Matrcula
A/D
R/l
Plataf
Fecha R / l
Dest.
Aerova
Lz
Is
02-08-2013
XX
PRTAP
00:01
23:53
SC EL
100
14-08-2013
XX
PRTAP
22:56
22:50
SCEL
22
06-09-2013
XX
PRTAP
01:50
01:48
SCEL
100
29-09-2013
02
PRTAP
11:04
11:00
SCCF
21
29-09-2013
Q2
PRTAP
20:40
20:38
SCEL
22
29-10-2013
Q2
PRTAP
15:27
15:18
SCEL
22
30-10-2013
02
PRTAP
21:59
21:55
SCEL
22
01-11-2013
02
PRTAP
00:49
00:43
SCEL
22
06-11-2013
02
PRTAP
22:19
22:14
SCEL
100
AIR DISPATCH CHILE

GENERAL DECLARATION
(Qutward/lnward)
wnoi or Operator : TAXI AEREO PIRACICABA L.TDA.
Marksof C-525
Nalinalily and Retjistrations PR-TAP - BRASIL
Depariure from ;
ANTOFAGASTA
- CHILE

Dalo: 01
AGOSTO 2013
Arrival al; SANTIAGO - CHILE

FF568207
CY274217

KAREN DOGGENWEILEK- 10.354.902-7
FELIPE PIZARRO C. - 1G.1G3.532-4

HERNN ROSAS R. - 8.574.245-0
MANUELA ENRIQUEZ O. -21.G61.928-5
Persons on boar known lo be suffering [rom lriass ulher Ihan For offcial USG Only
airsickness or the effects of accidents, as well as Ihose casos of
illness disernbaiked during the flight: ./r)/Wr:
Any oiher uonluii un boar wtcn mayitacl tu ifm |)raad-oF

disease:
NONE
Detalls
of
each
desirrscding
o
sanitary
treatment
(place,date,timo,method) during the flight. If no desinsccting has
been carried out th flight give detalls of most recent destnsecting:
SPRAYED
declared that all staments and particulars

contained in this General Declaration, Agent ot
Pilot in Comand in any supplementary forms
required to be presented with this General
Declarationare complete, exact true to the besl
of only my knowledge and that all through
passengers will continue/have continued on
the flight.
AIR DISPATCH CHILE

GENERAL DECLARATION
(Ouiward/lnwarcl)
Ownei o Operalot ; TAXI AEREO PIRACICABA LTDA.
Marksof C-525
Nationality and Regiatralions PR-TAP - BRASIL
Dalo : 14 AGOSTO 2013
Departuro froni :
ANTOFAGASTA - CHILE
Arrival ai:
SANTIAGO - CHILE

RODRIGO RODRGUEZ
CY274217
MARCO ENRIQUEZ O. -13.43G.389-4

KAREN DOGGENWEILLER -10.354.902-7
MATAS BERNALES L. - 17.441.145-K
t

FELIPE PIZARRO C. -16.163.532-4
HERNN ROSAS R. - 8.574.245-0
Persons on board known lo bo suferiny from Ihioss olher (han For Oficial US6 only
airsickness or the elfects of accidenta, as well as Ihosc cases of
illness disembarked during Ihe flight:
NONE
Any
disease:
NONE
Defer te ot
eacli1" desmsectmg
o
samttiry
trcatment
(place .date.lime.method) during the flight. If no desinsecting has
been carrled out he flight gve detalls of most reccnt desinsecting:
SPRAYED
declarcd that all staments and particulars

contained in this General Declaration, Agent o
Pilot n Comand in any supplementary forms
Declarationare complete, exact true to the best
passcngers will continu/nave contnued on
Me flight.
SIGNATURE AUTHORIZE
AIR D1SPATCH CHILE

GENERAL DECLARATION
(Oulward/lnward)
AGRICULTURA CUSTOMS, IMMIGRATIONS, AND PUBLIC HEATH
Markso C-525
Nationalily and Regislrations PR-TAP - BRASIL

Departure from :
ANTOFAGASTA - CHILE
Arrivul al:
TOTAL NUWIBER OF CREW
FF568207
RODRIGO RODRGUEZ
CY274217
Dalo: 05 SEPTIEMBRE
2013
SANTIAGO - CHILE

HERNN ROSAS R. - 8.574.245-0

PAMELA VILLALBA - 10.347.489-2
EDGARDO BRUNA - 4.49.33-7
t
Persons on board known to be sufferlng from illness olher (han Fot official USO only
airsckness or the effccts of accidents, as woll as those cases of
illrmss disembarkcd during the flight:
the
diseaso;
NONE
DottrHs-of-each-dcsinsectirrg-or-sanitary-trcntnrcnl
(placo, date, timo, rnetliod) during the flight. If no desinsocling has
been carried out the flight give detalls of most recent desinsecting:
SPRAYED
declarad that all staments and particulars

required to be presented with this Genera!
passengers will continu/nave continued on
the flight.
IGNATURE AUTHORIZED
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Owner o Opomlor : TAXI AEREO P1RAC1CABA LTDA
Marksof C-525
Nation;.iliy and Regislralions PR-TAP - BRASIL

eparture rorn :
ANTOFAGASTA
- CHILE
FF568207
RODRIGO RODRGUEZ
CY274217
Diilo: 29 SEPTIEMBRE 2013

Arrival al:
CALAMA
ACFT SIN PAX
ECLARATtON OF HEALTH
Persons on board knuwn lo be suifering from illness olher than Forofficial USO Only
airsickness or the ctfects of accidcnts, as well as Ihose cases uf
Illness disembarked riuring (he flight: hint.r
Any othr conltlon un boartJ Wlch mjy~t3~rcnhe spread of
disease:
NONE
D crtalls
of"cach
desinsecting w
sanitery
(reatmcn I
{place.dale.timo.method) during the flight. If no desinsecling has
been carried out the flight give detalls of rnosl recent desinseclinc):
SPRAYED
Crew Member Conccrned
[I doclared that all starnents and particulars

[contained in this General Declaration, Agent ot
required to be prcsented with this General
the flight.
- CHILE
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnwarcl)
AGRICULTURE, CUSTOMS, IMMIGRATIONS, AND PUBLIC HEATII
OwnororOperator : TAXI AEREO PIRACICABA LTDA.
Marksf C-525
Nationalily und Registraons PR-TAP - BRASIL
Deparlurc frorn :
ANTOFAGASTA
- CHILE
Arrival al: SANTIAGO - CHILE


RODRIGO RODRGUEZ
Dato: 29 SEPTIEMBRLi 2013
FF568207
CY274217

PEDRO GARCA - 15.170.594-4
WILLYGEISSE -7.702.361-1
ROLANDO JIMNEZ -9.035.375-6
Pcrsons on buard known In bo suf ferino; frorn llness olhar Ihan For offical USO Only
airsickness or Ihe efccts of accidents. as well as thoso casos of
illness disernbiirkod cluring the flighl: .,.-.-
NQNE
cuiiamon on
d istia so:
NONE
Dctalfs -of -each -dcsirrsrectfng -or sanrtary trcatmcn t

(place, date, time, melhod) during tlie flighl. If no desinsecling has
bocn carried out the flight give detalls of most recent desinsRcting:
SPRAYED
Crow Mcmber Concerned
declarad that all stamcnts and particulars

Pilot in Comand in any supplementary formsl
required to be presented with this General,
Declarationare complete, exact true to thc best
the flight.
SIGNATURA AUTHORIZED
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outwurd/lnward)
OwrierorOporator : TAXI AEREO PIRACICABA LTDA.
Mfjrksof C-525
Nalionality and Regislrations PR-TAP - BRASIL

Doparlure from :
ANTOFAGASTA - CHILE
Arrival al:

FF568207
RODRIGO RODRGUEZ
CY274217
Dale: 20 OCTUBRE 2013

SANTIAGO
- CHILE
NUMBER OF PASSENGERS PASSPOR T N"
ACFT SIN PAX
t
Pcrsons on board known lo be suferim] from Hness other Ihan For official USC only
airsickness or the effecls of accidenls, as well as those ctises uf
illnoss disembtirked during Iho flighl:
Any other (JonciiiiuTT~Dn~DonrJ"~wictr'rnay" iDcftrta~th5~5pragtt"' 'o

diseaso:
NONE
ctaKs of-cach-ctesinsrcting-o-sanitnry-trcatmnri t
(place, dal0,timo,melhod) during the fligH. If no dcsinsoctirij luis
een carrie out the flight give detalls of most recent desinsecling:
SPRAYED

ontained in this General Declaraton, Agent ot
passengers will contnue/have continued on
the flight.
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525

Departure from :
ANTOFAGASTA - CHILE

RODRIGO RODRGUEZ
Date: 30 OCTUBRE 2013

FF568207
CY274217
t
JAIME PARADA - 13.272.974-3

VCTOR FUENTES - 15.598.443-0
EDUARDO UBILLA - 12.884.543-3
AXEL PICKETT - 7.818.122-2
PAULINE PREZ - 16.208.315-5
Persons on board known lo be sufforing frorn illness other than For offical USO Otlly
alrsickness or Ihe effects of accidente, as wcll as Ihose cases of
illness disembarked during the flight: .,,-,.,,Any other condllloli on boar wlctt may leaff lo Iho sproad of
disease:
NONE
f
destnsuctiicj
DT
snmtary
(place, da te, time, rnethod) during the flight. If no desinsecting has
SPRAYED

required to be presented wth this General
the flight.
AIR DISPATCH CHILE

GENERAL DECLARATION
(Ouward/lnward)
AGRICULTURE, CUSTOMS, IMMIGRATIONS, AND PUBLIC HHATH
OWIKI ui Opornlor : TAXI AEREO PIRACICABA LTDA.
Markso C-525
Naliunulity und RegisLrations PR-TAP - BRASIL

Deparluro (rom :
ANTOFAGASTA - CHILE
Arrival al:

RODRIGO RODRGUEZ
ft
).';ito : 31 OCTUBRE 2013

SANTIAGO - CHILE
FF568207
MARCO ENRIQUEZ O. -13.43G.389-4

HERNN ROSAS R. - 8.574,245-0
CY274217
CRISTIAN WARNER - 12.869.443-9

FELIPE PIZARRO - 1G.1G3.532-4
RAL REQUENA - G.970.542-1
____________
Peisons oti board known lo be suffering frum illness othcr llian For offJCJal USO Oflly
airsickness or the effccts o accidenta, as woll as Ihose cases of
illness disembmked cluring the flight: .,.~A/fr
Arry oihor cuntitorrorrlJar wich
disease:
tu tha apreatf~of
NONE
DetaHs -of-cîct -destnsccttng -o -sarrrta 17 -tmatmenl

{place, date, timo.method) during [he flight. If no desinsocting lias
been carricd out Ihe flight give details of most recent desinsecting:
^
SPRAYED
Crew Member Conccrned

required to be presented with this Genera)
of only niy knowledge and that all through
>assengers will continu/nave continued on
he flight.
SIGNATURE AUTIIORIZED
AIR DISPATCH CHILE

GENERAL DECLARATION
(Oulward/lnwrd)
Owncr or Opovalor .TAXI AEREO PIRACICABA LTDA.
Marksof C-525
Nalionality and Rcginlralions PR-TAP - BRASIL
Departure frorn :
ANTOFAGASTA
- CHILE
Arrivif at:

FF5G8207
RODRIGO RODRGUEZ
CY274217
ft
Dalo: 00 NOVIEMBRE 2013
SANTIAGO

PEDRO GARCA - 15.170.594-4
DIEGO VARGAS - 16.048,937-4
DECLARATIQN OF HEAt.TH
Persons on board known to be suffering from illncss olher (han For offical use
airslckness or tlie effccls of accidenta. as well as Ihose cases of
illness dsembarke duriny (he llight: ft/n. /r
Any~7thSrJ cofldltldn on Oar WlGfl Miy
diseaso:
/VOA/5
ttr'ttTO^SpreIll ~of
D otatls-of cach-desirrst?ct ing-o-snnitory -treatrntrn I

(place, date, lime, metliod) during Ihe flight. If no desinsocting has
been carried out the flitjht give detalls of most recent desinsecting:
^
SPRAYED
Signed, f requerid.
declared that alt staments and parliculars

contained in this General Declaration, Agent o1
passcngers will continue/have continued on
the flight.
- CHILE
OPERACIONES MATRICULA PRTAP AD. EL LOA - CALAMA

Fecha
Acti
Aer
Vuelo
Reg
Matricula
A/D
R;I
Plataf
Fecha R / 1
Aerova
Dest.
Is
Lz
28-09-2013
Q2
PRTAP
16:2S
16:20
SCFA
35
29-09-2013
Q2
PRTAP
12:40
12:37
SCFA
35
GENERAL DECLARATION
(Outward/lnward)
Marksof C-525
Date : 29 SEPTIEMBRE
Departure from :
CALAMA
- CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
PE.CLARA_TION_OF_HEALTH
Persona on board known to be suffering (rom illness other ihan

arslckness or Ihe effects of accidenta, as well as those cases
of illness disembarked during the fligl ..-..,-
Arrival a t :
ANTOFAGASTA
- CHILE

PEDRO GARCA - 15.170.594-4
Any olher condition on board wich may lead lo the spread of

dsease:
NONE
Detalla ot each desinsecting or sanilary trealmenl
(place.dale.time.melhod) during Ihe flight. l( no desinsecting
has been carred oul Ihe flight gve delalls of most recent
desinsecling
SPRAYE
Cfew Mcmber Concerneti
I declarad that all staments and particulars

forms requlred to be presentad with this
contnued on the flight.
2013
AIR DISPATCH CHILE
GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Date : 28 SEPTIEMBRE 2013
Departure from :
CALAMA
- CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Arrival a t : ANTOFAGASTA
NUMBER OF PASSENGERS PASSPORT N<
ACFT SIN PAX

Persona on board known (o be suffering from illrtess ollier Ihan
alrsickness or Ihe efects of accidenls, as well as Ihose cases
O itlness disembaiked duiing ths fligt .(r.. l(-
Any olher condition on board wich niay lead to Ihe spread of

disease:
A/OA/E
Delalls o each desinsecling or sanitary trealment
(place,date,lime,method) durng the flight, If no desinsecling
has been carried oul the flighl give detalls of mosl recent
desinsecling:
SPRAYZ
Signed, if requerid

ot Pilot in Comand n any supplementary
General Declaratjonare complete, exact true
- CHILE
AIR DISPATCH CHILE
OPERACIONES MATRICULA PRTAP AD. DESIERTO DE ATACAMA - CALDERA

Fecha
Aer
Act
Vuelo
Reg
Matricula
A/D
R/l
Plataf
02-08-2013
XX
PRTAP
20:21
20:17
22-08-2013
XX
PRTAP
23:25
03-11-2013
Q2
PRTAP
21:42
Fecha R / I
Dest,
Aerova
SC BE
124
23:18
SCEL
21:36
SCEL
Lz
Is
22
22
OPERACIONES MATRICULA PRTAP AD. LA FLORIDA - LA SERENA

Fecha
Aer
Acti
Vuelo
Reg
Matricula
A/O
07-08-201 3
XX
PRTAP
23:50
23-09-201 3
Q2
PRTAP
09-10-2013
02
PRTAP
10-10-2013
02
01-11-2013
O2
R/l
Plataf
Fecha R / 1
Dest.
Aerova
Is
Lz
23:45
SCEL
24
13:28
18:23
SCOT
15:39
15:35
SCEL
24
PRTAP
12:08
12:04
SCEL
24
PRTAP
22:23
22:19
SCEL
24
O 7 AGO. 2I3
AIR DISPATCH CHILE
GENERAL DECLARATION
(Outward/lnward)

Owner or Operator : TAXI AEREO PIRAClCABA LTDA
Marksof C-525
Nationality and Registralions PR-TAP-BRASIL
Date
Departure from :
LA SERENA
- CHILE

. RICARDO COSTA FERREIRA
RODRIGO RODRGUEZ
07
AGOSTO 2013
Arrval a t : SANTIAGO
- CHILE
FF568207
CY274217
OgCLARATION OF HEALTH
Peisons on bonnl known to lie suffering (rom tllrifiss olher than
nirsrckness or the effects of accidenta, as well as Ifiose cases of
illness dispmbatked duritig the flight. .,_.,_
NONE

ROSSANA MUOZ -12.506.816-4
PEDRO GARCA - 15.170.594-4
For officat use only
Any olhet condillon on board wich may tead to Ihe Sfireid of

dmease'
NONE
DiTiE o eacFi desnsecOng "or iitary traiment
(place.dnte.tirrm.melhwi) Ouring Ihe flight lf no iJesinsecting
has beert oattied out Ihe Hight givfl _rfelalls of mnst rece
desmsectirto
SPftAYED
Signed, if requerid
Concemed
I declarad that all staments and particutars

contained in this General Dectaration, Agent
ot Pilot n Comand in any supplementary
forms requlred to be presentad wlth thls
General Dcciaratlonare complete, exact truc
all through passengers wlll contfnue/have
contlnucd on the flight.
/7
MANIFIESTO DK PASAJEIU)S LNTRADOS V SALIDOS
Carnet N1?
'PAX5 a S
T otaf
-Tar 10 Operacioues
Firma
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Owner or Operator : TAXI AEREO PIRACICABA LTDA
Marks of C-525
Date . 09 OCTUBRE
Departure from:
LA SERENA
- CHILE
Amval a t : SANTIAGO
- CHILE

RODRIGO RODRGUEZ
CY274217
ACFT SIN PAX
QECLARATION QF HEALTH
Persnns on bosrd known lo (JP surtanny from illncss othei than
aiisickness ur the effects of accidents, as well as thosn cases of
illriess rliscmbarkod durtng the flight. .,_. ._
WO/VE
Any other tondtton or board wich ma/ lead lo the spteatl of
d'Se;!Se
NONE
Deilis 51 ach desinsHctitg r sandary teSTment

i'plice.date.lime.method) riunng thR flight If no desinsecling
has been caniet out !he flight give detalls of mus leccnt
rlRsinaf>i:ting
SPRAYEO
Crow Mom

contained in this General Decaration, Agent
General Declaralionare complete, exact true
all through passengers will continu/nave
2013
For offcial use only
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525
Nationatity and Registrations PR-TAP - BRASIL
Date; 10 OCTUBRE
Departure from :
LA SERENA
- CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Persons on board known to be suffering frorn illness olher (han
airsickness or the effects of accidente, as well as Ihose cases of
illness disembarked during the tlight: .,. /(=
Arrival a t :
SANTIAGO
- CHILE
NUMBER OF PASSENGERS PASSPORT Na

LUIS ARGANDONA - 13.561.961-2
PEDRO GARCA - 15.170.594-4
Any ofher condition on board wich may lead (o the spread of

disease:
WOWE
Delalls of each desinsectirig or sanifary treatment
(place,date,time.method) during the flight. If no desinsecting
lias been carried oul the flight give detalla o most recent
desinsecting;
SPRAYED
Signad, if requerid.
Crew Memher Concerned
! declared that all staments and particulars

corita i ned in ths General Declaration, Agent
2013
SIGNATUREAUTHORIZED
AIR DISPATCH CHILE

GENERAL DECLARATION
(Qutward/lnward)
AGRICULTURE, CUSTOMS, IMMIGRAT1ONS, AND PUBLIC HEATH
Owner or Operaor : TAXI AEREO PIRACICABA LTDA
Marks of C-S25
Departure from :
LA SERENA- CHILE

RICARDO COSTA FERREiRA
FF568207
RODRIGO RODRGUEZ
CY274217
Arrivalat
SANTIAGO
-CHILE

HERNN ROSAS R. - 8.574.245-0
CRISTIAN WARNER - 12.8G9.443-9
RAL REOUENA - 6.970,542-1
For Officfilf USG Oll/y
NONIz
Any g'hf i'oiTl't'Tt
Detalknf
*y lnr tu tio wî^H'l
sarTi
ii<*wis*v-(tr'y
Signec, if requerid
I deca red that all stammits and parliculars

ot Pilot in Comand in any supplcmcntary
rcquired to be prcsented with this
u enera I Doclarationaro comolcte. exact truc
JIGNATURE ATMORIZfrU
5"
OPERACIONES MATRICULA PRTAP AP. ARTURO MERINO BENITEZ - SANTIAGO

Fecha
Aer
Acti
20-07-2013
XX
22-07-201 3
XX
23-07-20:3
XX
26-07-2013
XX
31-07-2013
XX
01-08-2013
XX
02-08-2013
XX
03-08-2013
XX
05-08-2013
XX
10
06-08-2013
XX
11
07-08-2013
XX
12
08-08-2013
XX
13
14-08-2013
XX
Vuelo
Reg
Matricula
AiD
RM
Plalaf
Fecha R ,' I
PRTAP
PRTAP
16:43
PRTAF
C1:Q2
0050
00 '50
23-Q7-2C13
u
u
u
u
PRTAP
12:33
12'22
12:22
PRTAP
19:43
1932
PRTAP
17:04
PRTAP
u
u
u
u
14
21-08-2013
XX
15
22-08-2013
XX
16
23-08-2013
XX
17
29-08-2013
XX
18
30-08-2013
XX
19
31-08-2013
XX
20
02-09-2013
XX
21
03-09-2013
XX
u
u
u
u
u
u
u
u
u
u
22
05-09-2013
XX
23
06-09-2013
XX
24
09-09-2013
XX
25
3-09-2013
XX
26
4-09-201 3
XX
27
6-09-2013
XX
28
7-09-201 3
29
23-09-2013
30
4-09-2013
31
5-09-201 3
32
33
Dest.
is
Lz
Aerova
SCCH
75
SBGR
49
26-07-2013
SCVD
181
19.32
31-07-2013
SC:E
37
T6'54
16:54
01-08-2013
SCFA
232
15:29
15:20
15:20
02-08-2013
SCAT
20
PRTAP
14:55
14.48
14:48
03-08-2013
SCIE
75
PRTAP
14 '26
14.19
14'19
05-08-20:3
SCJO
100
PRTAP
20:00
19:51
19:51
06-08-2013
SCJO
100
PRTAP
1706
1659
1659
07-08-2013
SCSE
32
PPTAP
18.35
18:28
18:28
08-08-2013
SCTE
100
PRTAP
1703
16:54
16:54
14-08-2013
SOBE
20
13:21
SCCH
13'09
1632
PRTAP
15.56
1546
15 46
21 -C8- 20:3
SCJO
98
PRTAP
13.47
13:39
1339
22-06-2013
SCAT
20
PRTAP
17:30
17-15
17 15
23-08-2013
SCI6
75
PRTAP
17 17
17-10
17 10
29-08-2013
SCTC
98
PRTAP
1449
14:39
1439
30-08-2013
SCIE
75
PRTAP
14'9
14.39
14.39
31-08-2013
SCGE
27
PRTAP
1 3 08
12:58
12.58
02-09-2013
SCTE
100
PRTAP
13-32
13.25
1325
03-09-2013
SCGE
27
PRTAP
1548
15.42
15'42
05-09-2013
SCFA
232
u
u
u
PRTAP
1637
SCIE
37
PRTAP
13.26
13:19
13 19
09-09-2013
SCCH
27
PRTAP
12'i6
12:08
12'08
13-09-2013
SCIE
75
PRTAP
16.31
16:21
1621
14-09-2013
SCDA
23
PRTAP
14:57
14:45
14.45
16-09-2013
SCCH
75
XX
u
u
PRTAP
236
226
1226
17-09-2013
S3FI
43
02
PRTAP
6:26
6 19
6-19
23-09-2013
SCSE
32
02
PRTAP
2.36
229
229
24-09-2013
SCVD
181
G2
PRTAP
6.24
6 14
6 U
25-09-2013
SCIE
75
6-09-2013
02
PPTAP
4.39
4.30
4:30
26-09-2013
SCTC
98
7-09-2013
02
PRTAP
00.31
00:24
00:24
27-09-2013
SCAR
23
34
8-09-2013
02
PRTAP
2.56
2'47
247
26-09-2013
SCCF
52
35
0-09-2013
02
PRTAP
230
2:30
2 19
29-09-2013
SCPQ
36
1-10-2013
02
PRTAP
540
5-33
533
01-10-2013
scie
75
37
3-10-20:3
02
PRTAP
547
535
535
03-10-2013
SCiE
75
16.29
00
38
4-10-2013
02
PRTAP
4 19
4.10
4 10
04-10-2013
SCCH
75
39
6-10-2013
02
=RTAP
3-01
2' 53
253
06-10-2013
SCIE
75
40
9-10-2013
32
JPRTAP
4 04
352
352
09-10-2013
SCSE
32
41
09-10-2013
Q2
PRTAP
17:26
17.15
17:15
09-10-2013
SCSE
32
42
13-10-2013
Q2
PRTAP
11:19
11:08
11:08
13-10-2013
SCAR
23
43
14-10-2013
Q2
PRTAP
15:17
15:08
15:08
U- 10- 201 3
SCTC
27
44
15-10-2013
02
PRTAP
15:51
15:44
15.44
15-10-2013
SCGE
27
45
18-10-2013
02
PRTAP
14:37
14:29
14.29
18-10-2013
SCIE
37
46
19-10-2013
Q2
PRTAP
12:08
11.58
11.58
19-10-2013
SCTE
100
47
23-10-2013
Q2
PRTAP
14:21
14:13
14:13
23-10-2013
SADF
51
48
25-10-2013
02
PRTAP
16:49
16-42
16:42
25-10-2013
SCIE
75
49
27-10-2013
02
PRTAP
14:26
14:20
14:20
27-10-2013
SCVD
181
50
29-10-2013
Q2
PRTAP
12:45
12:36
12:36
29-10-2013
SOF
232
51
30-10-2013
02
PRTAP
15'43
15.35
15.35
30-10-2013
SCFA
232
52
31-10-2013
02
PRTAP
14:41
14:34
14:34
31-10-2013
SCFA
232
53
01-11-2013
Q2
PRTAP
16:02
15:54
15:54
01-11-2013
SCSE
32
54
02-11-2013
Q2
PRTAP
12:56
1241
12:41
02-11-2013
SCTC
98
55
03-11-2013
02
PRTAP
13:30
13:22
03-11-2013
SCAT
20
56
04-11-2013
Q2
PRTAP
12:00
11.48
11:48
04-11-2013
SCIE
75
57
06-11-2013
02
PRTAP
11:36
11:28
11:28
06-11-2013
SCFA
232
53
07-11-2013
02
PRTAP
13:02
12-47
12:47
07-11-2013
SCVD
181
59
08-11-2013
02
PRTAP
13:45
13:37
13:37
08-11-2013
SCAR
23
60
0-11-2013
02
PRTAP
12:01
11:51
11 51
10-11-2013
SCIE
75
61
1-11-2013
02
PRTAP
14:09
13:48
13.48
11-11-2013
SCCH
62
2-11-2013
02
PRTAP
11-20
11:12
11:12
12-11-2013
SCIE
75
63
3-11-2013
02
PRTAP
15:04
14:52
14:52
13-11-2013
SCIE
75
64
4-11-2013
02
PRTAP
12:23
12:14
12:14
14-11-2013
SCIE
75
65
9-11-2013
02
PRTAP
4:32
421
4:21
19-11-2013
SBF!
49
1322
Txs Areo
Declaracin General
Piracicaba Ltda, (Salida/Llegada)
Operador: Taxi Areo Piracicaba Ltda.
Aeronave:
PR-TAP
Procedencia: SCEL-Saniago de chile
Lncar yPais: Brasil
Aeropuerto
General Declarador!
(Outward / Inward)
Voo n: Executivo
Fecha:20/07/20!3
Destino: SCCH- Chillan-chile
LucaryPais: Chile
Fecha de Partida
Declaracin Sanitaria
Declararon of Health
Enfermedades ultimo tratamiento
Plantas o virus ocurridas a bordo sanitario
Animles transportados:
Para uso Oficial
Hora de Salida
Hora de Llegada
Manifiesto de la Tripulacin - Crew Mamfest

Apellido y Nombre
Funcin
Nacionalidad
Ricardo Costa Ferreira
Comandante
Brasileira
Rodrigo Rodrigues Gimnez
Co-Piloto
Brasileira
Passaporie N"
FF568207
CY274217
Manifiesto de Pasajeros - Passenger Mamfest

Apellido y Nombre
Nacionalidad
N de Pasaporte/ RG
Fonseca, Augusto Csar de Souza
Brasileiro
RG-81996CM7
Ferrera e Uzeda, Auguslo Cesar
Brasileiro
FH 110834
Faria, Sabrina Adaini
Brasileira
RG-397408030
Fonseca, Silvia
Brasileira
RG-01078163-34
Manifiesto de Carga - Cargo Manifest

De los Bultos
Naturaleza de la Marcaderia
Peso
Tipo
Cantidad
Bruto
Observaciones
Observaciones
/ /
//
DECLARO que todo lo manifestado en esta declaracin general y en <nialqw<fr lisia que se acompae
referente a a aeronave mencionada es exacto y verdadero segn mi leal saber y entender.
FIRMA
PILOTO REPRESENTA!
UTQRIZADO
Form Approved
O.M.B. No. 1515.0002
DEPARTMENT OF THE TREASURY

UNITBD STATES CUSTOMS SERVICE
GENERAL
DECLARATION
(Outward/lnward)
AGRICULTURE. CUSTOMS. IMMIGRATION, AND PUBLIC HEALTH
19 CFR 122.13, 122.52, 122.54.122.73, 122.144
Owner or Operator TAXI AEREO PIRACJCAIfA
LTDA.
Flight
Marks of
Nationality and Registration JfRASIL/PR-TAP
Departure from
No.
PRVATE
Date aa.jnl.2Oi3 _
Arrival at SAO PAULO, BRASIL - SISGR
SANTIAGO, CHfTJE - SCEL

(Place)
(Place)
FLIGHT ROU'IING
("Place" Colurnn always lo list ongin. every en-ronle slop and destinatlon)
TOTAL NUMBER
PLACE
OF CREW
CREW:
RICARDO COSTA FERRElRA PPN:FF568207/BRA/
PPN:CY274217/BRA/
PÎRIGO RODRIGUES G.
NUMBER OF PASSENGERS
ONTHISSTAGE1)
Departure Place:
f-X:
AUGUSTO FONSECA
AUGUSTO FERRElRA
RiNAADAMIFARIA
PPN:RGB1995047mRA/
PPN:FH110834/BRA/
PPN:RG397408030/BRA/
SILVIA FONSECA
PPN:0107816334/BRA7
MARCO ENRIQUEZ OMINAMI PPN:13.436.3B9^1/CHI/
PPN-.12.869.443-9CHI
CRISTIAN WARNER
Embarking
Tbrough on
same flight
Arrival Place:
Disembarking
Through on
same tlight
Declaration of Health
Persons on board known to be suffering from llness other than airsickness or the
effects of accidents. as well as those cases of lliness disembarked during the tlight:
Jsp
/Hf."
Any other condition on board which may lead to the spread of disease:
Details of each disinsecting or sanitary treatment (place, date, time, method) during
the flight. If no disinsecting has been carried out during the fliqht give details of most
recent disinsecting:
\/7\e that
Signed, It required
and n any supplemenlary forms required tobe presented with this General
Declaration aie complete, exact and true to the best of my knowledge and
Ihat all through passengers will continu/nave continued on the flight.
t^^<[^<
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MINISTERIO DE DEFENSA NACIONAL

FUERZA
AERFA
DC
CHILE
f'
D.WEPOON GeNtnAL. OH nONAUT.CA C I V I L
> <>
MANIFIESTO DE PASAJEROS ENTRADOS Y SALIOS

Piloto
Copiloto
Sr ..... .
.....
. Licencia N*>. . . . . . . . . . . . . . . . . . . . . . . . ./Vence
" ..fl$&Qr*fe.......i^>^r.GJ>?,.. Licencia N........................./Vence
Sobrecargo
"..................................................................Licencia N?.........................../Vence
Mecnico
".................................................................Licencia N9........................../Vence
Mal. Aclt ....PR.Tt^VP...........Tipo........C.S^,............Tramo

Direccin
Paxs
./PAXS a $
Carnel N1?
C/M.
Total $
Son:
Fu. Turno Operaciones
Finanzas
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOMS, IWIMIGRATIONS, AND PUBLIC HEATH
Marksof C-525

Departure from :
SANTIAGO - CHILE

RODRIGO RODRGUEZ
Date: 31 JULIO 2013

Arrivalat:
CONCEPCIN
- CHILE
NUMBER OF PASSENGERS PASSPORT Nc
FF568207
CY274217

KAREN DOGGENWEILER - 10.354.902-7
LUIS RIVAS - 16.256.508-7
HERNN ROSAS R. - 8.574.245-0
Persoris on board known to be sutfering from illness other than For offical US6 Only
illness disembarked during (he flight: .,,_. (r _
NONE
Any otner randitiori on boari"wlch muy leaa tu tris apreati of
disease:
NONE
dnitary
Detalls
of
eacti
(pface.date.time.method) during the flight. If no desinsecting has
been carred out the flight give detalls of most receiit desinsecting:
SPRAYED
declared that all staments and particulars SIGNATURE AUTHORIZED

equired to be presented with this Genera
Qeclarationare complete, exact true to the besl
of oniy my knowledge and that all througr
he flight.
5"
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOMS, 1MMIGRATIONS, AND PUBLIC HEATH
Marksof C-525
Departure from :
SANTIAGO - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Date: 01
Arrivalat:
AGOSTO 2013
ANTOFAGASTA
-CHILE

KAREN DOGGENWEILER - 10.354.902-7
HERNN ROSAS R. - 8.574.245-0
Persons on board known lo be sulfering from illness other (han For Official US6 only
airsickness or Ihe effects of accidents, as well as those cases of
illness disembarked during the flight: t ,.,,_
NONE
Any other cundltlon or board wlch may lead tu (he spread of
disease:
NONE
Detatts
of
errcti
desnisectrng
o
sanitary
treatrrrent
(place,date,lime,method) during the flight. If no desinsecling has
SPRAYED
declarad that all staments and particular SIGNATURA AUTHORIZED

3ilot in Comand in any supplementary form
required to be presented with this Genera
Declarationare complete, exact true to the bes
of only my knowledgc and that all through
the flight.
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURA CUSTOWIS, IMWIIGRATIONS, AND PUBLIC HEATH
Owner or Operator : TAXI AEREO PIRAC1CABA LTDA
Matksof C-525
Nationality and Registrations PR-TAP- BRASIL
Date: 02
Departure frorn :
SANTIAGO
- CHILE
FF568207
RODRIGO RODRGUEZ
CY274217
Arrival al : COPIAPO - CHILE


CAMILO LAGOS - 14.259.010-7
DECLARATION QF HEALTH
Persans on txjid Known tu be suffering from iflness other than
aifsickness w the effects of accidents, as weil as thow cases ot
illnpss disenibaiked cturtng the flttjlit
., _
NONE
Forofficlal use only
Any olher condition on board wich niay lead tu the sprnacf of

diseasf*
A/OM;
etaTs oT eacTr desnTecng or 8amtary~~testmenl
(place,date,time,method) rturing ihc flight. If no desinsecting
has been catneci oiit Itie fiyht give ciclalls uf most fecenl
ciesitisocting
SPRAYED
Signed, if requerid
Crew Me:mber Concerned
I declared that all starnents and particutars

contained in this General Dectaration, Agent
General Declarationare complote, exact true
all through passengers will continue/havo
continuod on the flight.
AGOSTO 2013
IGNATURE AUTHORIZED
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOWIS, IMMIGRATIONS, AND PUBLIC HEATH
OwnerorOperator : TAXI AEREO PIRACICABA LTDA.
Marksof C-525
Departure from :
SANTIAGO - CHILE
TOTAL NUWIBER OF CREW

FF568207
RODRIGO RODRGUEZ
CY274217
Date: 03 AGOSTO 2013

Arrivalat:
CONCEPCIN

MARISELA SANTIBANEZ -12.880.575-3
PATRICIO STRAHOVSKY- 5.712.575-6
CRISTIAN WARNER - 12.869.443
SHEILA GINICOLO - BRA
Persons on board known to be sutferng rom illness other than For official US6 only
airsickness or the effects of accdents, as well as those cases of
illness disembarked during the flight: .,.,,_
NONE
Any other condlllon on Lboart WtCtnhay lOad to lhe spread of
disease:
NONE
D ets!
o
eacn
o
acivilen y
r) t
(place.date.time.melhod) during Ihe flight. If no desinsecling has
been carried out the flight give detalls of most rece deslnsecting:
SPRAYED
declared that all staments and particular

ontained in this General Declaration, Agent o
Pilot in Comand in any supplementary form
equired to be presented with this Genera
Declarationare complete, exact true to the bes
the flight.
-CHILE
itGNATURE AUTHORIZED
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Maiks of C-525
Departure from :
SANTIAGO - CHILE

RODRIGO RODRGUEZ
Dale: 05 AGOSTO 2013
Arrival at: OSORNO - CHILE

FF568207
CY274217
Persuns on board known to be suflermg fiom illness other thpn
aiistckiiess Of Ihe effects of accidents, as well as those cases of
iUness disenibafked duriny tlie flight A/r)Aur
SCAR TAPIA O. -12.809.152-1

BENJAMN GALLARDO F-17.727.931-5
PEDRO ABARCA C. - 9.463.645-0
FELIPE SNCHEZ Z. - 17.317.302-4
GLADY PALMA V. -6.384.372-5
CLAUDIA ULLOA P. - 19.205.598-1
For offlcial use only
Any other conclition on board wich may tead to ihe spread of

elsea se:
NONE
D'etalli o eacFii deslsctuy oi saary "treatment

(place,date,tnTie,method) dunitg the ffight. If no desinsrcttng
has beer rarried out the flight give detalls of inost recent
desinsectmg:
SPRAYED
Signad, if requerid
Crew Member Concarned
I deca red that all staments and particulars

forros required to be presented with this
General Declarattonare complete, exact truc
to the best oT only my knowledge and that
IGNATURE AUTHORIZED
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/inward)
OwnerorOperator : TAXI AEREO PIRACICABA LTDA
Marks of C-525
Departurefrom:
SANTIAGO
-CHILE
Arrival a t : LA SERENA
-CHILE
RICARDO COSTA FERREIRA FF5G8207

RODRIGO RODRGUEZ
CY274217
Persons on tioard knnwn to be suffering from illness other than
airsickness o ttie effects of accidenls, as welt as those cases of
illness disembarked during the fight
Any olher condjtron on board wich may lead to the spread of
d sea se:
NO/VE
Detaifs ~ ~ o ) e a c T i desnsecting o sanitary Ireatment
(p!ace,date,time.mttho<1) during Ihe flight If no desinsectincj
has heen canied oul the flight give detalls oF most recent
desinsectintj
SPRAYED
Signed, if requerid
I declared that all stamcnts and particulars

contained in this General Declararon, Agent
ot Pilot in Comand in any suppementary
General Declarationare complete, exact truc
all through passengers will contnue/have
continuad on the flight.

PEDRO GARCA - 15.170.594-4
For offficial use only
8! 5
7-0^
MANIFIESTO DE PA9AJEKOS KNTKADOg Y SALIDOS

Piloto
Copiloto
Sobrecargo
Mecnico
Sr. .iVr^'CfiAfeO
rr^P^'-T}fyfi'.
" .1 .l-O/'r*<*t.'?.. .x^V-f^''-'.VrV" '~
Licencia N" -S^>X?9 I
. . . t.ic<nctn N'1 .. v- r ' .<? ^ ' .../Vence .
"
Licencio M'.1
.''
Mat. Aut. IM'-"T./.'H'.
Tipo
Pus
Licencia N? .
7r"'wr....";^'
Tramo
.. :-~* .
Direccin
/Vfjnce
.
../Venen
^ ^ ~ ... ~v*^ ; T ^
Carnnt N(?
/PAXS a $
Son:
/Vence .
e/u. Total S
/..
lrim. Tiiruo Operaciones

^~.-f<
Firma Piloto
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Date: 14 AGOSTO
Departurefrom :
SANTIAGO - CHILE

RODRIGO RODRGUEZ
Arrivalat: TOCOPILLA
2013
-CHILE
FF568207
CY274217

SEBASTIAN GONZLEZ-13.912.629-7
HERNN ROSAS R. - 8.574.245-0
Persons on board known to be suffering from llness other than For Official US6 Only
airsickness or Ihe effects of accidents, as well as trise cases of
illness disembarked during the flighl: .,^.,^
A/OA/fc
Any other cundlttonOn board wlch may lead lo "Ihe spruad of
disease:
NONE
Dctetts
of
earh
desinsecting
or
sanitary
treatment
(place.date.time.melhod) during Me tight. If no desinsecting has
been carried out the tlight give detalls of most recent desinsecling:
SPRAYED

the flight.
SIGNATURE AUTHORiZED
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Departure from :
SANTIAGO - CHILE

RICARDO COSTA
FERREIRA
RODRIGO RODRGUEZ
Arrivai a t :
OSORNO
- CHILE
NUM8ER OF PASSENGERS PASSPORT N
FF568207
CY274217
DECLARATON OF_H!EALTH
Persona on buard known lo be suFfering from lness other than
airsickness or the effects of accidente, as well as those cases of
illnossrtisembaikeclduring the (fight A/nftc

MIGUEL MRQUEZ - 6.307.980-4
SEBASTIAN GONZLEZ- 13.912.629-7
-^ MAT4AS-NEGRE-TE 43r47,806-K
HERNN ROSAS R. - 8.574.245-0
MARCOS FUENTES - 16.574. 487-K
Any other conciition on boaid WK:h may lead to Iho spread of

clrsease:
NONE
De^tafls "~f"" ech desinsecting or snry f'feFit

(place,date,tiiTie,nielhod) diiiinfl the flight If no desinsectong
has been carriecl out the fiight give detalls of most rece
clesinsecting
SPRAYED
Signed, f requerid.
I declared tha all staments and particulars

all through passengers wiH continue/have
SIGNATURE AUTHORZE
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525
Departure from :
SANTIAGO
- CHILE
Arrival a t :
Date: 22
AGOSTO 2013
COPIAPO
FF568207
RODRIGO RODRGUEZ
CY274217

PEDRO GARCA - 15.170.594-4
ANDRS TAPIA - 10.966.492-8
Persone on board known to be sufering from llness other (han For official USe only
airsickness or ttie effects of accidents, as well as those cases of
illness disembarked during the flight:
NONE
Any otnur cunaitlon on board vttcn-may~tea[rtoTh-
dsease:
NONE
LJtstcillS
OT
ciCh
O6Sin66Cttiy
Ok
cirmdf y
- CHILE
TreculMt;! it
(place,datc,time,method) during the flight. tf no desinsecting has

SPRAYED

required to be presented with this Generafl
Declarationare complete, exact true to the besti
passengers will contnue/have continued on
the flight.
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Nationalily and Registrations PR-TAP-BRASIL
Date: 23 AGOSTO
Departure from :
SANTIAGO - CHILE

RODRIGO RODRGUEZ
Arris/al a t : CONCEPCIN
2013
- CHILE
NUMBER OF PASSEIMGERS PASSPORT N
FF568207
CY274217
Ptisons on boarc known to lie suffenng fiom illness other than
aiisickness or the offecls of accidents, as well as those cases of
illneas disurnbarked during the fliglit
Any othet contlition nn board wich may lead to the spread of
disease.
NONE
DetaFs of t;ac.Fidesinsecting o sanitary tfeatment

(place,late.time,method) dunng Ihe Hight. !( no desinsecting
has been canied out Ihe fliglit give detalla of rnast recent
desinseclifiy
SPRAYED
Ciew Member Concemed
I deca red that al) staments and particulars

ot Pilot in Comand in any supplomenlary
forms required to be presented with thls
General Declaratonare complete, exact true
ali through passengers wll continue/have
MARCO ENRIQUEZ O. - 13.43G.389-4

FELIPE PARADA - 13.272.974-3
RAFAEL CARAY - 9.542.263-2
SEBASTIAN GONZLEZ- 13.912.629-7
HERNN ROSAS R. - 8.574.245-0
AIR DISPATCH CHILE

GENERAL DECLARATION
(OutwarcJ/lnward)
AGRICULTURE, CUSTOMS, 1MMIGRATIONS, AND PUBUC HEATH
Marks af C-525
Nationalily and Registrations PR-TAP - BRASIL
Departure from :
SANTIAGO - CHILE
FF568207
RODRIGO RODRGUEZ
CY274217
FLIGHTROUTING PLACE
DECLARATIQN OF HEALTH
Pcisons on boaid known to be suflering from lllness other than
aiisit:kness or ttie elfecls of accidents, as well as litse cases of
lllness disembafked during the flight
(r)A/r
Any olher conclilion on board wich inay (ead to trie spread of

iliaease:
NONE
etals 07 "eicri rfsTnsectirig or

santtary treatirifiit
(p!?n;e,tlalR,tin)e,m!thod) ciiiting the flight. If no dcsinsecting
has beeri carnei out lie Right give detalls of most recent
desinseciny
SPRAYED
Signed. if requerid
Ciew Member Concerned

Affivalat:
TEMUCO - CHILE
NUMBER OF PASSENGERS PASSPORT N*

PATRICIA MORALES - 9.991.889-6
HERNN ROSAS R. - 8.574.245-0
EDGARDO BRUNA -4.498.633-7
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525
Date : 30
Departure from :
SANTIAGO
-CHILE

RODRIGO RODRGUEZ
Arrival a t :
AGOSTO 2013
CONCEPCIN
-CHILE
FF568207
CY274217
Persons on board known tu be suffering from illness other than
airsickness or the etfects of accidents, as well as those cases of
illness disembarked durincj the fltglil:
f-.,.lc

NATALIA ARAYA -16.573.619-2
PEDRO GARCA - 15.170.594-4
ANDRS TAPIA -10.966.492-8
Any ollier conclition on boar wich may lead to Ihe spread of

disease:
NONE
Delalls of
each clesinsecting or sanitary trealment
(place.date.lime.method) during Ihe flight. If no desinsectmg
has been carretl out the flight gtve delalls of most recent
desinsecliny:
SPRAYED

AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURA, CUSTQMS, IMMIGRATIONS, AND PUBLIC HEATH
MarKsof C-525
Nalionality and Registralions PR-TAP - BRASIL
Date ; 31 AGOSTO 2013
Departure from :
SANTIAGO
- CHILE
TOTAL NUMBER OF CRlW

FF568207
RODRIGO RODRGUEZ
CY274217
DECLARATION OF..HEALTH
Porsons on board Knowti to be suffenng ftom jlness ollier (lian
airsickness or the efects f acddonls, as well as those cases of
llness discmbarked dunng the flight:
Arrival at
LOS ANGELES
NUMBER OF PASSEWGERS PASSPORT Na

PAULINE PREZ -16.208.315-5
PEDRO GARCA - 15.170.594-4
Foroficial use only
Any other concittinn on board wich may ead to the spreacl of

dtsease'
NONE
eals of eacFi~~ desmsedma or siTatv leiiien
(fjlace.clate.tiuie.uiethod) dutitig the tlght If no desinseclmg
fias boen canifitl out Uie flight glvo detalla of most recont
desinsecting"
SPRAYED
Signed, if requerid
Crew Membsr Concerneri
I dcclared that alt staments and particulars

contalned in this General Declaration, Agent
forms required to be presented wlth this
General Doclarationare complete, exact truc
to the best of only my knowledgc and that
all throujh passengers wll continu/nave
continued on the fllght.
- CHILE
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Nationality and RegistrationsPR-TAP-BRASIL
Date: 02 SEPTIEMBRE
Departurefrom:
SANTIAGO
-CHILE
FF568207
RODRIGO RODRGUEZ
CY274217
FLJGHT ROUTING PLACE
Persons on board known lo be suffering (rom illness other (han
airsickness or tde elfecls of acciclenls. as well as Uiose cases of
iilness disernfoarked duiing llie flight: A/n.,r
Arrival a t :
PTO. MONTT
-CHILE

WILLY GEISSE -7.072.361-1
PEDRO GARCA - 15.170.594-4
ANDRS TAPIA -10,966.492-8
Any other conilion on board wich may lead to the spread of

diseaso:
NQNE
Delalls of eacli desinsecling or sanitary (realrnent

(place,dale.time.method) during (he flight. If no desinsecting
has been carried out the flighl give detalls of most rece
desinsecling;
SPRAYED
Crew Metnber Concetned
I declared that all stamonts and particuiars

ot Pilo! in Comand in any supplementary
2013
SIGNATURE AUTHQRIZED
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGR1CULTURE, CUSTOMS, IWIWIIGRATIONS, AND PUBLIC HEATH
Owner or Operator : TAXI AEREO PIRAC1CABA LTDA,
Marks of C-525
Departurefrom:
SANTIAGO
- CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Arrival a t :
LOS ANGELES

KURT CARRERA - 12.61G.GG7-2
Persons on board known lo be stiftering from Hness other Ihan
airsckness or the elfecls of accidents, as well as those cases of
iilness disembarked during the flight: ,.,_.,.-
NON E
Any other condilion on board wch may lead to the spread of

disease:
NONE
Delalls
of each desinsecting or sanitary treatment
(place,dale,tme,method) during the lghl. If no desinsecting
has been carred out the flight give delalls o most recent
dcsinseclng.
SPRAYEO

contained in this General Dcclaration, Agent
ot Pilot in Comand in any supplomentary
all through passcngers will continu/nave
- CHILE
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Departure from :
SANTIAGO - CHILE

Arrival a t :
ANTOFAGASTA - CHILE
FF568207
RODRIGO RODRGUEZ
CY274217
3ersons on board known to be sufferirtg from llness other than
airsickness or the effects of accidenls, as well as those cases o
llness disembarked dufing the flight:
,_
NONE

HERNN ROSAS R. - 8.574.245-0
PAMELA VILLALBA - 10.347.489-2
Any uthei uundliluH un boaid wk;li may lt;tid (u Ihu yprtitiiJ of

discaso:
NONE
Tîftn^
\ji
ca\.,i i
ucir i>dxiiuij
ui
^><ii inoiy
LI cniiiic;i i
(place, date,time,rnethod) during the flight. If no desinsecting has

been carned out the flight give detalls of most recent desinsecting:
SPRAYED
Signed, f requerid
Crew Membcr Concerned
1 declared that all staments and particulars 3IGNATURE AUTHORIZED

Pilot in Cornand in any supplementary forms
required to be presented wth this Genera
the flight.
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525
Nationality and Regisrations PR-TAP - BRASIL
Date: 06 SEPTIEMBRE
Departurefrom :
SANTIAGO - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Persons on board known to be suffering (rom illness other than
airsickness or the effecls of accicients, as well as Ihose cases of
illness disembarked curing the flight:
Arrivalat:
CONCEPCIN
- CHILE

FELIPE PIZARRO C, -16.163.532-4
HERNN ROSAS R. - 8.574.245-0
Any olher conclition on board wich may lead to the spread of

discase:
NONE
Detalls
of eact desinsecling or sani'tary treatment
(place.dale.time,method) during the flight. If no desinsecling
has been canied oul the flighl give detalls of most recent
desinsecling:
SPRAYED
Crew Meinber Concerned

forms requred to be presented with this
General Declarationarc complete, exact true
2013
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
OwnerorOperator ; TAXt AEREO PIRACICABA LTDA.
Marks O C-525
Nationality and Registrations PR-TAP -BRASIL
Departure from
SANTIAGO
-CHILE
Arrivalat: CHILLAN
-CHILE
RICARDO COSTA FERREIRA FF5G8207

RODRIGO RODRGUEZ
CY274217

PEDRO GARCA - 15.170.594-4
DtiCLARATION QF HEALTH
Petsons on Lxjard known to be suffering fram illness other (lian
airsickntiss or the effects of occidents, as wcll as ttiose cases of
illness disembarked duiiny the flight
Any olher concition on boartl wich may lead lo Itio spiead nf
dSaSe
NONE
etals o eicTi" "tosscim} cir~~~3aTtaTy treatrefi

(place.date.time.method) dunng ihe flight. If no desinsecting
has l>een carne oul the flight giVH cletallii of most recent
destnsectmg'
SPRAYED
Signed, if requerid..
Crew Membflr Concetnef
I declared that ali staments and particulars

contafncd in this General Declaration, Ayent
to the best of only my knowlodge and that
aII through passengers will contlnue/have
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Owner or Operator : TAXI AEREO P1RACICABA LTDA.
Marks of C-525
Departurefiom
SANTIAGO
-CHILE
FF568207
RODRIGO RODRGUEZ
CY274217
Persons on board known lo be suffcrmg from iltness olher than
airsickness or ihe cfecls of accidents, as well as those cases of
illness isembarked cluring the fligtit:
,,-.1,;[-
Arrival at:
CONCEPCIN

PEDRO GARCA - 15.170.594-4
WILLY GEISSE - 7.072.361-1
Any other condition on board wicli may lead lo Ihe spreacl of

disease:
NONE
Detalls
of
each destnsecting or sanitary
treatmeni
(place,date.lime,method) durmg the flight, If no desinsecting
has been carried oul the flight give detalls of most recent
desinsectiny:
SPRAYED

forms required to bo presented with this
-CHILE
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Natonality and Registrations PR-TAP - BRASIL
Departure from :
SANTIAGO - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Persons on board known lo be suffering from llness otlier than
aifsickness or the effecls of accidents. as welt as those cases of
illness disembarked during the (ligtit:
Arrivalat:
IQUIQUE - CHILE
MARCO ENR1QUEZ O. -13.436.389-4

HERNN ROSAS R. - 8.574.245-0
CRISTIAN JAMETT - 13.237.896-7
NONE
Any other conciition or board wich may load to the spread of

disease:
NONE
Detalts of each desinseding or sanitary

Ireatmen
(place,date.lime.melhod) duriny (he flighl. If n desinsecting
tas been carned out the flight gve detalls of most recent
desinsecting;
SPRAYED
Crew Meniber Concerned

contained Jn this General Declaration, Agent
2013
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/Inward)
AGRICULTURE, CUSTOMS, IMWIfGRATIONS, AND PUBLIC HEATH
Marksof C-525
Date: 16 SEPTIEMBRE
Depariure from:
SANTIAGO
- CHILE
FF5G0207
RODRIGO RODRGUEZ
CY274217
Arrh/al a t :
CHILLAN
- CHILE
NUMBEER OF PASSENGERS PASSPOKT N*

PEDRO GARCA - 15.170.594-4
Persons on lioanl Miown (u be suffomig from i/ln8s other Ihan
airsickness ot the efecls of accidente, as well as tliose cases of
illness ilisenibirked duting the fliyht
For officfal use only
Any othef conihlion on boaid wici may tead to the spreaJ of

rlisease:
_
NQNP
Tetals of eaci" '"Jesinsectiny" of sanitary Iroatmeht
(place.date.lime.inettiotl) dunrig Ote fliyht. If n dftalnsecting
has been cairre out the fliylit give detaltr. of most recent
destnsecting
SPRAYED
Signed, l requerid
Crew Mentbct Concernd
I declared that all staments and partlculars

containcd in this General Dcclaration, Agent
ot Pllot in Comand in any supplementary
forms requirod to be presented with this
General Declarationaro complete, exact true
to the best of only ni y knowledge and that
all through passengers wilt contlnuo/havo
contintied on tho fllght.
2013
SIGNATURE AUTHQRIZED
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marfcs of C-525
Date . 17 SEPTIEMBRE
Departure frorn :
SANTIAGO - CHILE
2013
Arrival at : FOZ DE IGUACU -BRASIL


RODRIGO RODRGUEZ
CY274217
RODRIGO ASTUDILLO B. - 10.030.593-3

JUAN DANIEL ESCOBAR - 15.443.173-K
Persons un koarrf knowri lo ba sufferirtf/ ftom ifness other ttisn
;ifsrcknes3 o [lie effects of accufents, ns well as tliosfi cases of
illness disembaiked during the flighf
._
NONE
Forofficla use only
Any other con<i(ion on board wich niay lescf to (he spreacj of

disease:
_
NONB
of aciT dsinaeclig or ""santary tTeatmeiii

(place,date,tifT)e,mPthod) duriny the flighl. If no lesinsecling
has been carnett out tlie llight give detalla of most recent
teainsectiny
SPKAYED
INHI \) >'-" i'1 ''"' '
Signed, if requerid
Crew Meini>er(7

forms requlred to be presentad wlth this
all through passengers wiil continue/have
contnued on the fllght.
IGNATUREAUTHORIZED
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/Inward)
AGRICULTURE, CUSTOMS, IMWIIGRATIONS, AND PUBLIC HEATH
Mariis of C-525
Nationaliiy and Registrations PR-TAP - BRASIL
Date: 23 SEPTIEMBRE
Departure from:
SANTIAGO
-CHILE
FF568207
RODRIGO RODRGUEZ
CY274217
Arriva! al : LA SERENA

PEDRO GARCA - 15.170.594-4
Forofficial use only
Any olher coniiitiori on boatd wich may lead to Ihe pread of

disease
NONE
Detalla o each destose c t i n j i o samlty trealment

(place.date.time.tneUiodj during trie Hight If no desinsectitty
has been canied out Ihe ftighl gjve details of most receul
desinsecting:
SPRAYtD
Sgnec, if requerid
I dcclared that all staments and particulars

contatned in this General Declaration, Agent
General Deciarationare complete, exact true
conttnued on the flight.
-CHILE
Persons on board known to be sutfciing (rom flness other (han
airstckncss or Ihe effects of accidente, as wnll as those cases of
liness disembarked dunng the flight A,nAJ|r
2013
K5NATURE AUTHORIZriD
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Departure from :
SANTIAGO
- CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Arrival at: VALDIVIA
- CHILE

PEDRO GARCA - 15 .170.594-4
Persona on board known to be sufferrng from illness other than
airsickness or the effects of acddents, as well as those cases of
illness djsembarked durtng the flight RfnMfr
Forofficialuse only

disease:
NONE
Detalla of each desinsecling or sanitary treatment

{place,date,time,method) during the flight. If no desinsecting
desinsecting:
SPRAYED

forros required to be presented with ths
SIGNATUREAUTHORIZE
30
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Nationalty and Registrations PR-TAP - BRASIL
Date ; 25 SEPTIEMBRE
Dcparture from :
SANTIAGO - CHILE
FF568207
RODRIGO RODRGUEZ
CY274217
Arrivalat:
CONCEPCIN
2013
-CHILE
NUWI8ER OF PASSENGERS PASSPORT N c
MARCO ENRIQUE2 O. -13.436.389-4
DECLARATION Of HEALTH
Persons on board known to be suffeiing from illness olher than
airsickness or the effects of accidente, as wel! as those cases of
illness disembarked during the flicjhl:
FELIPE PIZARRO C. - 16.163.532-4
HERNN ROSAS R. - 8.574.245-0

CRISTIAN WARNER-12.869.443-9
Any other condilion on board wich may lead to the spread of

di sea s;
A/O/VE
DeFalls of each desinsecting or sanaiy treatmeiit
(place.date,lime.melhod) tiuring Ihe flight. If no desinsectiriy
hus buen carne oul tho (light yive detalls o niost recent
cfesinsecling:
SPRAYF.O
Signed, f requerid.
Crew Meniber Concerned
I declared that atl stamcnts and partculars

contained in ths General Declaration, Agent
all through passcngers will continue/have
continued on the flight
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOMS, IMM1GRATIONS, AND PUBLIC HEATH
Marks of C-525
Depatturefrom:
SANTIAGO
- CHILE

RODRIGO RODRGUEZ
Arrival at : CALAMA
- CHILE
FF568207
CY274217
Persons on board Known to be suffering tiom illness ollier llian
airsir.kness or thc effects of accidents, as well as trise cases of
illness ctisembiikecJ during (he ftighi: A,.-,.,r

PEDRO GARCA - 15.170.594-4
Any olher coiuilion on board wicti niay lead to Ihe spread o(

dlsease.
NONE
Delalls of each dcsinsecling or sanitary lieatmenl
(place.date.liine.rnelhod) during the flighl. If no desinsectiny
has been carnee! oul the flighl give delalls of riiosl rece
desinsficting:
SPRAYED
Crew Meinber Concerned
I declared that all starnonts and particulars

ot Pilot in Comand in any supplemcntary
AIR D1SPATCH CHILE

GENERAL DECLARATION
(Outwarcl/lnward)
Marks of C-525
Date ; 30 SEPTIEMBRE 2013
Departure from :
SANTIAGO
- CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Pefsons on boaid known to be sutfeiiny fiom iflness olher Ihan
airsidtness or Ihe effecls of accidenls, as well as those cases o
illness disernbifked durlng the tlight: .,,-,Mr-
Arrivalat:
DALCAHUE

PEDRO GARCA - 15.170.594-4
Any othei cundition on board wich may lead lo the spread of

disense.
NONE
Detalls of tiach desinsecling or sanilary trcalment
(place.date.lirne.method) duiing the flighl, If no desinsecting
has been carned oiil the flight give detalls of mos! recent
desmsecliny:
SPRAYED
Crew Meinber Concemed

General Declarationare complete, cxact true
- CHILE
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Date : 01 OCTUBRE
Departure from ;
SANTIAGO - CHILE

FF5G8207
RODRIGO RODRGUEZ
CY274217
Persons on board known to be suffering (rom illness other than
airsickness ot Ihe effects of accidente, as we as those cases of
illness diaembarked during the flighf. .fr,,,/fr
Arrival a t : CONCEPCIN
2013
- CHILE
CRISTIAN WARNER - 12.869.443. -9

MARISELA SANTIBANEZ - 12.880.575-3
AXEL PICKETT -7.818.122-2
BORIS BRIONES - 17.045.360-3
WALTER ZUNIGA - 7.890.290-6
Any other condilion on board wich may lead lo the spread of

dsease
NONE
Delalls of each desinsecling or sanitary treatment

(placa,dae.time.method) during the Right. If no desinseclng
has been cairied out the flighl give detalls of mosl rece
desinsecliny:
SPRAYED

3(o
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/inward)
Marksof C-525
Departure from :
SANTIAGO - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Persons on boafd known lo be suffering froin illness olher than
airsickness o tlie effects of accidenta, as well as Ihose cases of
iHness disemba keii dunng the lliyhl: .,,-,,,,-
Arrival at : CONCEPCIN - CHILE


HERNN ROSAS R. - 8.574.245-0
LUIS RIVAS -16.25G.508-7
Any olher conttilion on board wich may lead lo Ihe spread o

disease:
NONE
Delalls
o each desinsecling or sanilary treatrnenl
(place.date.lime.melhod) duriny the flighl. If no desinsecting
has been carriec out Ihe flight give detalls of mosl recent
desinsecling:
SPRAYED
Crew Mernher Concernerl

AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGR1CULTURE, CUSTOMS, IMMIGRATIONS, AND PUBLIC HEATH
Marksof C-525
Date : 04 OCTUBRE 2013
Departure from :
SANTIAGO
-CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Persons on board known lo be suffering rom illness olher Ihan
airsickness or Ihe etfects of acctdenls, as well as those cases of
illness disernbaiked during Ihe flight: A/nWF:
Arrival at:
CHILLAN -CHILE

PEDRO GARCA - 15.170.594-4
JAVIER KROON - 17.405.506-8
MARIO QUEVEDO -10.649.982-9
Any other conciilion on board wlch inay lead lo the spread of

disease:
NONE
Delalls of each cesnsecling or sanitary treatment
(place,date,lime,method) during the flight. If no deslnsecting
has been cairied oul Ihe flight give detalla of most recent
desinsectirig.
SPRAYED
Crew Meiiibef Concerned
I declared that all stamcnts and particulars

contained in this General Deciaration, Agent
SIGNATURE AUTHORI2EO
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOWIS, IWIIVIIGRATIONS, AND PUBLIC HEATH
Marksof C-525
Nationaty and Registrations PR-TAP-BRASIL
Date: 06 OCTUBRE
Departure from;
SANTIAGO
-CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Arnval a t :
CONCEPCIN

PEDRO GARCA - 15.170.594-4
Auy otier condilion on board wich may lead to the spread of
disease.
NONE
Delalls o( each desinsecliny ur samtary Irealment

(place,date,time,melhod) during the flight l( no desmsecling
desinsecling
SPRAYED
Crew Mernber Concerned

forms rcquired to be presented with this
General Declarationaro complete, exact truc
-CHILE
NUMBER OF PASSENGERS PASSPORT Nl
Persons on board known to be suffermg from llness olher than
airsickness or the effects of accidenta, as wetl as those cases ot
illness disembarked during the Ilight:
2013
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRiCULTURE, CUSTOMS, IMMIGRATIONS, AND PUBLIC HEATH
Marks of C-525
Date: 09 OCTUBRE
Departure from :
SANTIAGO
-CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Persons on boarcl known lo be sulferng from illness other (han
airsickness or tlie effects of accienls. as well as those cases of
illness diseinbaiked during the fiiyht. ,,-,.Jtr
Arrival at:
LA SERENA
-CHILE

JORGE LABARCA - 16.079.812-2
Any oiher condition on board wich may lead to tho spread of

disease
NONE
Detalis of each desinsectiny or sanitary Ireatmenl
(plaee,date,time,method) during ttie flight. If no desinsecting
has been carried out the flight give detalls of ttiost recent
desinseclmg:
SPRAYED

all through passengers wl continue/havc
2013
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOWIS, IWIWIIGRATIONS, AND PUBLIC HEATH
Owner or Operator .TAXI AEREO PIRACICABA LTDA.
Marks of C-525
Date ; 09 OCTUBRE
Departure from :
SANTIAGO
- CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Arrival a t :
LA SERENA
EDGARDO B R U N A - 4.498.633-7
LUIS A R G A N D O N A - 13.561.961-2
Any other condition on board wich may lead to Ihe spreai) of

distase
NONE
Delalls of euch desinsecting or sanitary trealrnent
(place.date,time.rnelhod) during llie fliyht. If no desinsccting
lias been carrieU out the llight gve detalls of mosl recenl
desinsccting:
SPHAYED
Crcw Mcmber Conceined
I dectared that all stamcnts and particulars

all through passcngers will continue/have
- CHILE
NUMBER OF PASSENGERS PASSPORT N c
5ECIARATION OF HEALTH
l'ersons on board known to be suffeiing from Hness other than
airsickness or the etfecls of accidenls, as wel! as tliose cases of
itlness disembaiked during ttie llighl
NONE
2013
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Date : 13 OCTUBRE
Departurefrom:
SANTIAGO
- CHILE
TOTAL N U M B E R OF CREW
FF568207
RODRIGO RODRGUEZ
CY274217
L
Persoiis on board known lo be suffering (rom illness other (han
airsickness of the eflecls of accidente, as well as those cases of
illness clsernbaikecl during the flight.
Arrival a t : ARICA
2013
- CHILE
PEDRO GARCA - 15.170.594-4

MANUELA GUMUCIO
Any other condilion on board wich may load lo tho sptead o(

cfisease.
NONE
Detalls of
eacli desjusectiri)
or sanitary
ireatment
(place.date.lime.method) during the flight. If no desinsecling
has been cnriied out the (lighl yive detalls of tnost recenl
desinsecting:
SPRAYED
Signed, if requerid
Crew Membor Concerned

containcd in this General Declaration, Agcnt
42,
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Date ; 14 OCTUBRE 2013
Departure from :
SANTIAGO - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Persona on boatd known to he suffering from llness olher than
aifsickness or the etfects of accidents. as well as those cases of
illness disernbarked during (he flighl: .,.,,-.
Arrivai at: TEMUCO - CHILE


NATALIA
ARAVENA
Any other coiulion on board wich rnay tead lo the spread of

disease:
NONE
Delalls of each desinsecting or sanitary treatment
(place.dale.lime,melhod) during the flighl, If no desinsecting
has been carried oul tlie ffight give delalls of most rece
desinsecling:
SPFtAYED
Crew Member Conceined
I declared that al) stamcnts and particulars

fornis required to be presented with this
alf through passengers will continue/have
- 15.438.294-1
AIR DiSPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOMS, IMMIGRATIONS, AND PUBC HEATH
Marksof C-525
Departurefrom:
SANTIAGO
-CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Arrival a t :
LOS ANGELES
NUMBER OF PASSENGERS PASSPORT N(

PEDRO GARCA - 15.170.594-4
Persons on board known tu be suffering from illness olher than
airsickncss or the effects of accidente, as well as tliose cases of
illness disembarked rluring the flight: A/riM{r
Aiy other conditiun on board wich may lead to the spread of
disease:
NONE
Detalts of each desinsecling or sanary treattnent

(place,date,time,niethod) durituj Ihe flight. If no desinsecting
has been carned oul the flight give detalls o( rnost recent
desiiisecting:
SPRAYED

contained n this General Declaration, Agcnt
all through passengers will contmue/have
-CHILE
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525
Date: 18 OCTUBRE
Deprtate from:
SANTIAGO
-CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Arrival a t :
CONCEPCIN
VERNICA NAVEA -12.857.301-1

AXEL PICKETT- 7,818.122-2

tisease:
NONE
Delais o each desinsecting or sanitary trealment

(place.dale.time.rnelhod) during Ihe fliglit. If no desinsecling
has been carred out the flight give detalls of mosl recent
dcsinsecting:
SPRAYED
I cleclarcd that all staments and particulars

containod in this General Declaration, Agent
forms rcquired to be presented with this
-CHILE
Persona on board known to be suffcring from llness other Ihan
aif sickness or the effecls of accicents, as well as Ihose cases of
llness disembarked during tlie flighi:
2013
SIGNATURE AUTHORIZEO
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525
Departure rom :
SANTIAGO
- CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Arrival at : PUERTO MONTT
- CHILE
KAREN DOGGENWEILLER
- 10.354.902-7
Persons on boatd known lo be siiffering (rom illness olher than
airsickness or the effccts of accidenls, as well as Ihose cases of
tllness disemburkec) cluring Ihe fliytil:

PABLO ZAMORA - 12.847.409-9
KURT CARRERA - 12.616.667-2

disease:
Delalls of each desinsecting or sanitary Ireatmenl

(place.dale.time.rnelhod) dtirinc) Ihe flight. If no desinsecting
lias been canied oul Ihe fliyhl givo delalls of most rece
desinsectmg-
SPRAYED
Signed, if requerid
Crew Mernber Concerned

contained in this General Declaratton, Agent
forms required to be prcsented with this
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOMS, JMMIGRATIONS, AND PUBLIC HEATH
Marks of C-525
Date : 23 OCTUBRE
Departure from :
SANTIAGO
-CHILE
Arrival at:
2013
BS. AIRES - ARGENTINA
FF568207
RODRIGO RODRGUEZ
20002288X
Pcrsons on buar known to be suffenng (rom illness oidor Ihan
aiisiukness or Ihe effects of accidenls, as well as Ihose cases of
llness disembarked during the tlight: ,,-,..,-
MARCO ENRIQUEZ-OMINAMI GUMUCIO

13.436.389-4 DOB - 12/06/73
CRISTIAN WAGNER VILLAGRAN
12.869.443-9 DOB 18/03/75
Any olher condilion on bnard wich rnay leacl lo Ihe spread of

disease.
NONE
Oetalls of each destnsecling or sanitary treatment
(place.dalc.lime.method) during the flight. If no desinsectng
has been carricd oul the flight gve detalls of niost recent
de sin sed ig
SPRAYCD
Crew Meinber Conceined

ot Pilot in Comand in any supplemontary
forms required to bo presented with this
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOWIS, IWIIVIIGRATIONS, AND PUBLIC HEATH
Marks of C-525
Departure from :
SANTIAGO - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Persons on board known to be suffering (rom illness olher than
airsckness or Ihe effects of accidents, as well as those cases of
illness disembarked during the flight: .._.,.-
Arrivalat:
CONCEPCIN

HERNN ROSAS R. - 8.574,245-0
MAX PASTOR - 13AK77182
NONE
Any olher condition on board wich may lead to the spreatl of

disease
NONE
etalls of each desinsecting or sanitary treatment

(place,dale.time.method) during the flight. If no desinsecting
has been carrieci out the flight give detalls of most recent
desinsecting:
SPRAYED
Ciew Member Goncerned

forms requircd to be presentad with this
-CHILE
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Date : 27 OCTUBRE
Departure from :
SANTIAGO
- CHILE
FF56B207
RODRIGO RODRGUEZ
CY274217
Arrival at: VALDIVIA

PEDRO GARCA - 15 .170.594-4

dSCaSe:
NONE
B e a l l s f each desnsectjng or sanitary treatmenl

(place.date.time.method) during the flight. If no desinsecting
desinsecting:
SPRAYED

General Dcclarationaro complete, exact true
- CHILE
Persons on board known to be sutfering from illness other than
illness disembarked during the flight: wnA/r
2013
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Date: 29 OCTUBRE
Departure from :
SANTIAGO - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Arrival at:
2013
ANTOFAGASTA - CHILE

alrsickness or Ihe effecls or accidents, as well as those cases or

disease:
A/O/VE
e t a s o f each desinsecting or sanitary treatment
(place.date.time.method) during Ihe riight. ff no desinsecting
has been carried out Ihe flight give delalls of most recent
desinsecting:
SPRAYED

ot Pilot In Comand in any supplementary
"0
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525
Departure from :
SANTIAGO - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217

Arrival a t :
ANTOFAGASTA - CHILE

VCTOR FUENTES - 15.598.443-0
Persons on board known to be suffering from illness otfier than
aifsickness or the effects of accidents. as well as those cases of
_
NONE
Any other condition on board wich may lead to the spiead of

disease:
NONE
D e t a l l s o f e a c t i d e s i n s e c t i n g r s a h i t a r y treatment
(place.date,time,method) during the flight. If no desinsecting
desinsecting;
SPRAYED
I declarad that al) staments and particulars

all through passengers wMI continue/have
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525
Departure from : SANTIAGO - CHILE
RODRIGO RODRGUEZ
Arrival al: ANTOFAGASTA - CHILE

FF568207
CY274217
Persons on board known to be suffering from lness other than
lness disembarked during the flight:
A/O/VE

HERNN ROSAS R. - 8.574.245-0
RAL REQUENA -6.970.542-1

disease:
NONE
DetaiTs 6 7 a c f i d e s i n s e c t n g or saltarytreatrriet
(place.date.time.method) during the flight. If no desnsecting
desinsectng:
SPRAYED

ot Pilot in Comand In any supplementary
to the best of only rny knowledge and that
SIGNATUREAUTHORIZED
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGR1CULTURE, CUSTOMS, IWIMIGRATIONS, AND PUBLIC HEATH
Marks of C-525
Departure from :
SANTIAGO - CHILE
RODRIGO RODRGUEZ
LA SERENA - CHILE
Arrival at:
FF568207
CY274217
Persons on board known to be suftering from illness other Ihan
airsickness or the effects of accldents, as well as those cases of
illness disembarked during the flight A/n./r

HERNN ROSAS R. - 8.574.245-0
RAL REQUENA - 6.970,542-1
Any other conclition on board wich may lead to the spread of

disease:
NO/VE
Detalls of each desmsecting or sanitary trealment

(pl3ce.<Jale,time,melhod) during the flight. If no desinsecting
has been carried out the flight give detalts of most recent
desnsecling:
SPRAYED
Signed, f requerid.

contnue on the flight.
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Owner or Operator : TAXI AEREO PIRACtCABA LTDA.
Marks of C-525

RODRIGO RODRGUEZ
CY274217
arsickness or the effects of accidents, as well as those cases of

illness disembarked durlng the flight:
Arrival ai: TEMUCO

PEDRO GARCA - 15.170.594-4
EVELYN TAPIA - 15.514,537-4
For offtcial use only
NONE
Any other condition on board wch may lead to Ihe spread of

disease:
NONE
Delaso? each esnsectigor sanrtary treatmenl
(p!ace,date.time,method) durlng the flight. If no desinsecting
has been catned out the flight gve detalls of most recent
desinsecting:
SPRAYED
Signed, f requerid.

General Decfaratonare complete, exact true
- CHILE
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Departure from :
SANTIAGO - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Persons on board hnown to be suffering from illness olher than
illness disembarked during the flighl:
Arrival at:
COPIAPO

HERNN ROSAS R. - 8.574.245-0
CARLOS OMINAMI ALDREI MONTEIRO -FB363755

disease:
NONE
t S e t a f s o eacn"dssecting r samtary treatment
{place.date.time.method) during the fiight. If 'no desinsecting
has been carried out the fllght give detalls of most recent
desinsecting:
SPRAYED

forms required to be presentad wlth this
continued on the llight.
- CHILE
S1GNATURE AUTHORIZED
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Owner or Operator : TAXI AEREO PIRAC1CABA LTDA.
Marks of C-525
Date: 04 NOVIEMBRE
Departure from : SANTIAGO
- CHILE
Arrival at: CONCEPCIN
2013
- CHILE
FF568207
RODRIGO RODRGUEZ
CY274217
Persons on board known to be suffering from llness other than
airsickness or the effects of accdents, as well as those cases of
illness disembafked during the fiight:
_.,,_
NONE

PEDRO GARCA - 15.170.594-4
MARIO QUEVEDO - 10.649.982-9
JORGE SANHUEZA - 14.022.372-7
Forofficial useonly

dlsease:
NONE
Oetalls of each desmsecting or sanitary treatment
{place,date,tme.rnethod) during the flight. If no desnsecting
has been carried oul the flight give detalls of most recent
desinsecting:
SPRAYED
Signed, f requerid.
Crew Member Corrcerned

containcd in this General Declaration, Agent
forms requircd to be presentad with this
to the bcst of only my knowledge and that
5(o
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Date: 06 NOVIEMBRE
Departure from :
SANTIAGO
- CHILE
FF568207
RODRIGO RODRGUEZ
CY274217
Arrival a t :
ANTOFAGASTA

PEDRO GARCA - 15.170.594-4
DIEGO VARGAS - 16.84B.937-4
Any other condition on board wich may lead to the spead of

disease:
NONE
Detalis of e a c h d e s i n s e c t i n g o r sanitryiTeatment
(place.date.time.method) during the flight. tf no desinsecting
desinsecting:
SPRAYED
Signed, f requerid.
! declared that all staments and particulars

- CHILE
Persons on board known to be suffering trom illness other than
airsickness or the effects of accidents, as wel! as those cases of
Illness disembarked during the flight;
NONE
2013
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525
Date : 07 NOVIEMBRE 2013
Departure from :
SANTIAGO - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Persons on board known to be suffering from iiiness other llian
airsickness or the effects of accidents. as well as those cases of
iiiness dsembarked during the ight: A/n.JP
Arrival a t : VALDIVIA - CHILE

HERNN ROSAS R. - 8.574.245-0
DIEGO VARGAS - 16.848.937-4
Any olher condition on board wich may tead lo the spread of

disease;
NONE
Delalls of each desinsecting or sanitary treatment
(place.daie.time.metriod) during the flight. If no desinsectirig
desinsecting:
SPRAYED

SIGNATUREAUTHORIZE
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Arrival at: ARICA - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Persons on board known to be sufferlng from illness olher than
airsickness or tha effects of accidents, as well as those cases of
,_. _.
NONE

HERNN ROSAS R. - 8.574.245-0
CECILE TRON MURATORI - 23.386.51 6-8
Por official use only

disease:
NONE
Detals of each desinsecting or sanitary treatment
(place,date,time.melhod) during the flight. If no desinsecting
has been carried out the flight give detalls o most rece
desinsecling:
SPRAYED

contained n this General Declaration, Agent
ot Plot in Comand in any supplementary
forms requlred to be presented with this
General Declaraionare complete, exact true
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOWIS, IMMIGRATIONS, AND PUBLC HEATH
Marksof C-525

RODRIGO RODRGUEZ
FF568207
CY274217
Persons on board known to be suffering from illness other (han
airsickness or the effecls of accidents, as well as those cases of
illness disembarked during the flight: ,iriMf:
Arrival a t : CONCEPCIN - CHILE

MARCO ENRIQUEZ O . -13.436.389-4

HERNN ROSAS R. - 8.574.245-0
CIRO COLOMBARA - 10.220.552-9
For officiat use only

disease:
NONE
Detalls o each desinsecting or santary treatment
{place.date.time.fnethod) during (he flight. If no desinsecting
has been carried out the flight give delalls of most recent
desinsecting:
SPRAYED

AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOMS, 1MMIGRATIONS, AND PUBLIC HEATH
Marks of C-525
FF568207
RODRIGO RODRGUEZ
CY274217
Arrival at: CHILLAN - CHILE

CARLOS OMINAMI - 5.470.678-2
Persuns on board known to be suffering from llness other than
airsickness or the effects of accidents, as well as Ihose cases of
llness disembarked during the flight: .,n.,rr
Any other condilion on board wich may lead to Ihe spread of

disease:
A/OA/E
Details l e a c h d e s i n s e c U n g o r sanitarytreatment
(place.date,time,method) during the flight. If no desinsecting
desinsecting:
SPRAYED
Signed, f requerid.

contained in this General Declaraton, Agent
to the bcst of only my knowledge and that
ail tliroucjh passengers will continu/nave
SIGNATUREAUTHORIZED
fc/l
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOWIS, IWIMIGRATIONS, AND PUBLIC HEATH
Marksof C-525
FF568207
RODRIGO RODRGUEZ
CY274217
Arrivalat: CONCEPCIN

CRISTIAN GALAZ - 7.474.296-3
alrsickness or the effects of accidents, as well as those cases of
ilness disembarked during the flight: .._..,,-
Any other condition on board wich may lead to Ihe spread of

di sea se:
WONE
Detalls of each desmsecting or sanltary treatment

(place,date,time,method) during the flight. If no desinseding
has been carried out the flight give detalla of most recent
desinsecting;
SPRAYED

- CHILE
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525

Departure from :
SANTIAGO
- CHILE
FF568207
RODRIGO RODRGUEZ
CY274217
2013
Arrival at: FOZ DE IGUACU -BRASIL

Date: 19 NOVIEMBRE
ACFT SIN PAX
êrsons on board known to be suffering from llness other than
airsickness or the efects of accidents, as well as those cases f
lness disembarked during the flight:
Any uiher uoiidlilun un budid wluli may ldd tu the spruad uT

disease:
NONE
place,dale,time,method) during the flight. If no desinsecting has

SPRAYED
Signed, if requerid
1 declared that al) staments and particulars SIGNATURE AUTHORIZED

Jilot in Comand in any supplementary forms
Declaration a re complete, exact true to the best
iassengers will continu/nave continued on
the flight.
OPERACIONES MATRICULA PRTAP AD. CARRIEL SUR - CONCEPCIN

A
Fecha
Aer
Vuelo
Acti
31-07-2013
XX
04-08-2013
XX
24-08-2013
XX
30-08-2013
XX
07-09-2013
XX
1 3-09-201 3
XX
u
u
u
26-09-2013
Q2
02-10-2013
Q2
02-10-2013
10
04-10-2013
11
12
Reg
Matricula
PRTAP
PRTAP
PRTAP
PRTAP
N
N
02
07-10-2013
A'D
Plataf
Fecha R / l
Dest.
SCEL
14:49
14:42
00:33
00:29
21:38
PRTAP
N
N
02
02
18-10-2013
02
23:55
R/l
23:47
Aerova
Lz
Is
70
SCTE
71
SCEL
70
21:34
SCEL
70
01:15
01:07
SCEL
70
PRTAP
22:37
22:30
SCEL
70
PRTAP
00:20
0017
SCEL
70
PRTAP
14:38
14:34
SCGE
PRTAP
20:45
20:40
SCEL
70
PRTAP
00:04
23:58
SCEL
70
PRTAP
23:21
2316
SCEL
70
PRTAP
21:55
21 51
SCEL
70
S
N
13
26-10-2013
02
PRTAP
14.46
14:40
SCGE
14
04-11-2013
Q2
PRTAP
19:18
19:14
SCEL
70
15
10-11-2013
02
PRTAP
22:27
22:19
SCEL
70
16
12-11-2013
02
PRTAP
23:17
23:12
SCEL
70
17
13-11-2013
Q2
PRTAP
21:17
21:10
SCEL
70
18
14-11-2013
Q2
PRTAP
19:02
18:58
SCEL
70
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Owner or Operator TAXI AEREO P1RACICABA LTDA.
Marksof C-525
Nationallty and Registrations PR-TAP-BRASIL
Date
Departure from :
CONCEPCIN - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Persons on board known to be suffcring Itotn illness othef than
airsickness or Ihe fiflocts of accidents. as well as Ihose cases of
illness disembarked during the flight
.,..
NONh
Arrival at
31 JULIO 2013
SANTIAGO - CHILE

MARCO ENRIQUEZ O. - 13.43B.389-4
KAREN DOGGENWEILER -10.354.902-7
LUIS RIVAS - 16,256.508-7
HERNN ROSAS R. - 8.574.245-0
Any other condition on boafd wich mny lead lo lh spread of

diseasc
NONE
Delals 5f""eacK 'desmsedimj ~oF sanitary
(place.date,tinie,mcthod) dunng the flighl If no dsinsecting
has bepn carrintj out the flight yive detalls o rnost rocen!
desinsecting
SPRAYEO
Signed, if requerid
Crrw Membf>( Cncer ned
I declared that all staments and particutars

ot Pilot in Comand in any supplcmentary
forms required to be presented with ths
General Doclarolionare complete, exact truc
all through passengers will continuo/nave
continuad on the flight
AIR D1SPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Owner or Operalor : TAXI AEREO PIRAC1CABA LTDA
Nationaty and Registrations PR-TAP-BRASIL
Departure from :
CONCEPCIN - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Persons on board known lo be suffeimg (rom illness other than

iltncas diaembatked dunng Ihe flight .,.,,_
NONE
\f C-525
Date : 04 AGOSTO 2013
Amvalat:
- CHILE
MARISELA SANTIBANEZ -12.880.575-3

PATRICIO STRAHOVSKY- 5.712.575-6
CRISTIAN WARNER - 12.869.443 .
SHEILA GINICOLO - BRA /f^, \N OF HEALTH
Dealls'"" of eacrf desiisecing or sariary reatnient

(place.date.lime.method) dming the flight l( no desinsecbny
has been carred out 8ia flight give tletalls of most recent
desrnsecting
SPRAYED
Signed, if requerid
berConcftined
\E AUTHORIÊD
ot Pilot in Comand in any supptementary
forms requlred to be prescntcd with this
General Dcclarationare complete, exact truc
MONTT
Any other condition on board wich may lead to tlie spread o

disease
NONE
Cre
PTO.
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525
Date : 30
Departure from ; CONCEPCIN
- CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Arrival a t :
AGOSTO 2013
SANTIAGO
- CHILE

NATALIA ARAYA -16.573.619-2
PEDRO GARCA - 15.170.594-4
EVELYN TAPIA - 15.514.537^1
ANDRS TAPIA -10.966,492-8
I/
-v' ln
'"' V V ^ . -,
Persons on board known lo be suffering from illness other Ihan
airsickness or Ihe effects of acctdents, as well as those casos of
"1
Any other condition on board wich may lead to Ihe spread of

disease:
NONE
Oetalls of each desnsecting or sanitay treatment
(place.date.time.method) during the flighl. If no desinsecting
has been carried out Ihe flight give detalls of mosl recent
desnsecling:
SPRAYED

all through passengers wilt continue/have
l\>
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
HATH
Owner or Operator : TAXI AEREO PIRAClCABA LTDA.
Marks of C-525
Nationality and Registratrons PR-TAP - BRASIL
Departure from ; CONCEPCIN - CHILE
FF568207
RODRIGO RODRGUEZ
CY274217
FLIGHTROUTING PLACE
Persons on board known lo be suffering from illness olher than
airsickness or Ihe effects of accidenis, as well as Ihose cases of
illness disembarked during Ihe flight: .,,-,. ,P
Arrival a t : SANTIAGO - CHILE


HERNN ROSAS R. - 8.574.245-0
k)
For offciai use only
Any olher condition on board wich may lead to the spread of

disease,
NONE
Detalls of each desirtsecling or sanitary treatment
(place.date.Iime.method) durlng the flight. If no dosinsecting
has been carried out the flight gve delalls of mosl rece
deslnsecling:
SPR.4 YED

General Declarationaro complete, exact true
AIR DiSPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
j.^""

Marksof C-525
Date: 13 SEPTIEMBRE
Departure from :
CONCEPCIN
- CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Persons on board known to be sutfering (rom llness other than
airsickness or the effects of acciclents. as wetl as tliose cases of
llness disembarked during the flight: A,nAfc.
Arrival a t :
2013
SANTIAGO - CHILE

PEDRO GARCA - 15,170.594-4
WILLY GEISSE- 7.072.361-1
^)
Any olher condilion on board wich may lead to tlie spread of

disease:
NONE
Detalls of each deslnsectlng or sanitary trealmont
(place,dale,lime,melhod) during the flight. If no desinsecling
has been carred oul the flight give detalls of trust iecen(
desinsecting:
SPRAYED
Signed, if requerid

contained tn this General Declaration, Agent
<o
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks Of C-525
Date ; 25 SEPTIEMBRE
Departure from :
CONCEPCIN - CHILE
FF568207
RODRIGO RODRGUEZ
CY274217
Persons on board hnown lo be suffeiing from illness other than
airslckness or Ihe effecls of accldents, as well as those cases of
Illness disembarked during the light:
Arrival a t :
SANTIAGO - CHILE

HERNN ROSAS R. - 8.574.245-0
CRISTIAN WARNER -12.869.443-9
SEBASTIAN GONZLEZ - 1 3.91 2.629-7
EDGARDO BRUNA * 4,498.633-7
i)
Any other condilion on board wich may Icad to Ihe spread of

dtsease:
NONE
D e l s o f each desinsecting or sanitary treatment
(place.date.time.method) during ihe flight. If no desinsecling
has been carried out the flight gve detalls of mosl recent
desinsecting;
SPRAYED
I doclared that all staments and particulars

contained n ths General Declaration, Agent
forms requred to be presentad wth this
2013
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOWIS, MMIGRATIONS, AND PUBLIC HEATH
Marksof C-525
Departure from :
CONCEPCIN - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Arrival a t :
LOS ANGELES - CHILE
/^"
CRISTIAN WARNER^ 12.869.443.-9

Persons on board known to be suffering from llness olher [han
airsckness or the effecls of accidents. as well as those cases of
illness disembarked during the flight
.,_.,,_
NONc
,;,(;
For Offcial use only
Any olher condition on board wich may lead to the spread of

disease:
NONE
Detalls of each desinsecting or sanitary treatment
(place.date.tima.method) during the flight If no desinsecting
has been carried out Ihe flight give delalls of most recent
desinsecting:
SPRAYED
Signed, if requerid
Crew Member Concetned

AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Owner or Operalor : TAXI AEREO PIRACICABA LTDA.
Marks of C-525
Departure from :
CONCEPCIN - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Arrival at:
SANTIAGO - CHILE
fr, '.
CRISTIAN WARNER - 12.869.443.-9
WALTER ZUNIGA - 7.890.290-6
J V rr-o
DECLARATtON OF HEALTH
Persons on board known to be suffenng (rom llness olher (han
airsickness or the effects of accidenta, as well as Ihose cases o
illness disembarked durlng the flight. -,OA/f-
Any olher condltion on boafd wich may lead to the spread of

disease.
NONE
Detalls of each desmsecting or sanitary Ireatment
(place,daie.time.method) durlng (he flighl. ir no desinsectmg
has been carried out [he flighl give detalls of most recent
desinsectmg:
SPRAYED
Signed, if requerid

all through passengers wll continue/have
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Date; 03 OCTUBRE 2013
Departure from :
CONCEPCIN - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
FLIGHTROUTING PLACE
Pefsons on board known to be suffering frcm Illness other llian
arsickness or [he effects of accidente, as well as Ihose cases of
iliness disembarked during tha flight: .,_..,_
NONE

NUMBER OF PASSENGERS PASSPORT N c
x;

HERNN ROSAS R. - 8.574.245-0
SEBASTIAN GONZLEZ-13.912.629-7
LUIS RIVAS -16.256.508-7
JORGE SNCHEZ R. - 16.006.668-7
Any olher condilion on board wich may lead lo Ihe spread of

disease;
NONE
Detalls o? echdesinsecting or sniiary trealmei
(place.date.time.method) durlng tha flight. If no desinsecting
has been carried out Ihe flight give dealls of most recen!
desinsecting:
SPRAYED
Signed, if requerid...
Cfew Member Concemed

contaned in hfs General Declaration, Agent
forms required to be presentad with thls
to the best of only my Knowledge and that
/IO
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Owner or Operator : TAXI AEREO PIRAC1CABA LTDA,
Marks of C-525
Nationaiity and Registrations PR-TAP - BRASIL
Date: 07 OCTUBRE
Departure from : CONCEPCIN
- CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Persons on board known to be suffering from illness olher than
illness disembarked dunng the flight
/nA.F
Arrival a t : SANTIAGO
- CHILE

PEDRO GARCA - 15.170.594-4
</?.
For official US6 Oflly
Any other condition on board wich may lead to the spread o

disease:
A/O/VE
(place.dale,time,rnethod) during the flight if no desinsecting
desinsecting:
SPRAYED
Signed, f requerid.

contatned in this General Deca catin, Agent
forms requred to be presented with this
2013
SIGNATURE AUTHORIZD
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Departure from :
CONCEPCIN - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Arrival at : LOS ANGELES
- CHILE

HERNN ROSAS R. - 8.574.245-0
Persons on board known to be suffering from illness ollier than
airsicktiess or the effects of accidenta, as well as those cases of

MAX PASTOR - 13AK77182
Any other condition on board wich may lead lo (he spread of

dlsease:
NONE
Delalls of each desinsecling or sanitary Irealmonl
(place.daie.time.method) during Ihe flight, If no desinsecling
has bcen carried out the flight glve detalls of most rocen!
desinsocling:
SPRAYED

contalned n this General Declaration, Agent
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Owner or Operator : TAXI AEREO P1RACICABA LTDA
Marksof C-525
Date
Departure rom:
CONCEPCIN
- CHILE
FF568207
RODRIGO RODRGUEZ
CY274217
Persons on board known to ba suflcnriq fiorn lnpss othw tlian
airsickness o( the eller.ts of acaclents, as well as Ihose CHSTS of
illness disfimbaiked during ttie Ihyht
NONh
04 NOVIEMBRE
Arnval at : SANTIAGO
KAREN DOGGENWEILLER - KT.354.902-7

PEDRO GARCA - 15.170.594-4
rvo/ve
etalls o ach "Jesnsccting or sao'itry treatrnent

(place,date.tirne.method) dunng thp flight II no
has been carriod out (he fligtil give delalis o mosl
desinsecting
SPRAYED
Signed, if requerid
Concerned
I declarcd that all staments and particulars

General Declarationare complete, cxact truc
alt through passengers wili continue/have
continucd on the flight.
- CHILE
Any otner condition on board wich muy leod to Ihe spread of

dlsease
2013
IGNATURE AUTHORIZED
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Owner or Operator : TAXI AEREO P1RACICABA LTDA
Marksof C-525
Departure from :
CONCEPCIN - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Date
Arnval at
10 NOVIEMBRE 2013
SANTIAGO - CHILE

HERNN ROSAS R. - 8.574.245-0
CRISTIAN WARNER -
Persons on board known to be sutfenng (rom illness other Iban
airsickness or the effects of accidenta, as wpll as Ihcise cases of
illness disemharkec dunng the flight Ar../t;
12.869.443-9

MARCOS ORTZ - 10.079.303-2
CIRO COLOMBARA - 10.220.552-9
Any othet condrtion on board wtch may lead lo Ihp spicad o

disease
NONE
Dtails 6T eacFT""esmsectfg cr sinitai y e'fiftent
(place.dato.lime.metliod) dunng Ihn fStght if no desmspcliny
has been canied out the flight give dotals of niost iecnnt
desinsectmg
SPRAYED
Signed, if requerid
Ctew Member Concernod

/15-
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Departure from :
CONCEPCIN
- CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Persons on board known to be sufferng rom illness other Ihan
airsickness or the effccls of accidenls. as well as Ihose cases ot
illness disembarked during Ihe flighl:
._
Arrival at : SANTIAGO
- CHILE

PEDRO GARCA - 15.170.594-4
/ a \"
L.v
5/
Any other condition on board wich may lead to Ihe sproad of

disease;
NONE
Detalls of each desinsecling or sanilary trealmenl
(place,date,time,niethod) during Ihe flight. If no desinsecting
has been catried oul the flight give detaNs of most recent
(lesinsecling
SPRAYED

contaned in this General Declaration, Agent
llb
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525
Nationality and Registraions PR-TAP - BRASIL
Departure from :
CONCEPCIN
-CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Arrival a t :
SANTIAGO - CHILE

MAURICIO GARAY - 13.457.174-8
DECUARATION OF HEALTH
Persons on board known to be sufering (rom tiness other tnan
airsickness or ihe effects of accidents. as wetl as Ihose cases of
liness disembarked during Ihe flight: A/n.,c
Any olher condition on board wich may lead to Ihe spread of

disease:
NONE
Uetalls of eachdesisecing i sanltary frealmenl
(place,date, lime, method) during the fllght. If no desinsectiny
has been carried out Ihe flighl give detalls of mosl recen!
desinsecling:
SPRAYED
Signed, f requerid.

ot Pilot fn Comand in any supplcmentary
AIR D1SPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOMS, IMWIIGRATIONS, AND PUBLIC HEATH
Marksof C-525
Departure from :
CONCEPCIN
- CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Arrival at ; SANTIAGO

CRISTIAN GALAZ - 7.474.296-3
(>)
Persona on board known to be suffering frorn illness olher Ihan
arrsickness or tlie eftects of accldenls. as well as those cases of
illness disembarked during Ihe flighl: A/n,f/z
Any other condilion on board wich may lead lo Ihe spread of

disease:
NONE
tais o acfi desinsecting or sanitary trealment
(place,date,time,method) during the flight If no desinsecling
has been carried oul Ihe flight give detalls of most rece
desinsecting:
SPRAYED
Signed, if requerid
Craw Member Concerned

- CHILE
4:
OPERACIONES MATRICULA PRTAP AD. MAQUEHUE - TEMUCO

Fecha
Aer
26-07-201 3
XX
29-08-2013
03-09-2013
26-09-2013
Acti
Vuelo
Reg
Matricula
PRTAP
XX
XX
02
14-10-2013
02
02-11-2013
02
07-11-2013
02
A/D
R/l
Plataf
Fecha R / l
Oest.
Aerova
Is
Lz
21:09
21:05
SCEL
99
PRTAP
23:00
22:55
SCEL
70
PRTAP
23:46
23:43
SCEL
70
PRTAP
22.24
22:19
SCEL
70
PRTAP
22:08
22:02
SCEL
70
PRTAP
20:42
20-38
SCEL
PRTAP
22:46
22 '42
SCEL
70
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525

Departure from :
TEMUCO - CHILE

DRIGO RODRGUEZ
Date: 26 JULIO 2013

Arrivalat:
SANTIAGO - CHILE
FF568207
CY274217

CARLOS DE URRESTI -14.025.579-3
HERNN ROSAS R. - 8.574.245-0
Persons on board known to be suffering from illness other than For offJCal USC Only
arsickness or (he effects of accidente, as well as those cases of
Any oiher cond Ilion on board wlch may lead to the spT53d of
disease:
NONE
ftt*3ry
tre3tiytnt
u 6*3 lis
o
63(in
ucintn i
(place, date.time,method) during the flight. If no desinsecting has
SPRAYED
I declared that all staments and particular

Pilot in Comand in any supplementary form
required to be presented with this Genera!
the flight.
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525
Departure from :
TEMUCO - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Date: 29 AGOSTO

PATRICIA MORALES - 9.991.889-6
HERNN ROSAS R. - 8.574.245-0
Persons on board knowo to be suffering frorn illness other than FOT offical USG only
airsickness or the effects of accidents. as well as those cases of
illness disembarked during the flighl:
NONE
Ahy blhf"ofittltlof~o.n board wlch may lead to Ihe sfiread of
disease:
NONE
DC
(place,date,time,method) during the flight. If no desinsecting has

been carried out the flight give detalls of most recent desinseciing:
SPRAYED

contained n this General Declaration, Agent ot
Pllot in Comand in any supptementary forms
the flight.
2013
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525
Departure from :
TEMUCO
- CHILE

ODRIGO RODRGUEZ
Arrival at:
SANTIAGO
CHILE
FF568207
CY274217

PAULINE PREZ-16.208.315-5
PEDRO GARCA - 15.170.594-4
KURT CARRERA - 12.616.667-2

disease:
NONE
(place,date,time,method) during the flight. If no desinsecting
jas been carried out the flight give detalls of most recent
jsinsecting:
SPRAYED

AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525
Departure from : TEMUCO - CHILE
Arrival a t :
SANTIAGO - CHILE

RODRIGO RODRGUEZ
CY274217
Dersons on board known to be suffefng from illness other [han
airsickness or the effects of accldsnts, as well as those cases of
llness disembarked during the flight: MrtMf:

ANDRS TAPIA - 10.966.492-8
PIERO JARA - 16.018.080-3
FABIN SALINAS - 17.600.689-7
Any uiliei cuiiuiuuii un buatd wii.li niay ISH lu (Im spiudd o
disease:
NONE
'place,dale.time,method) during the flight. If no desinseding has

leen carried out the flight give detalls of most recent desinseding:
SPRAYED
Signed, f requerid

Pilt in Comand in any supplementary forms
the flight.
3IGNATURE AUTHORIZED
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Departure from : TEMUCO - CHILE
FF568207
RODRIGO RODRGUEZ
CY274217
airsickness or the effects of accidents, as well as those cases o
illness disernbarked d urina the flight: . ,_ . ._
NONE

Arrival at:
SANTIAGO - CHILE
AXEL PICKETT JAIME PARADA BORIS BRIONES PAULINE PREZ NATALIA ARAVENA
ny oiher conlilon 011 boa id wluli muy lead iu ilie spiead of

dsease:
NONE
'place,dale,time,method) during the flighl. If no desinsecting lias

aeen carried out the flight give detalls of most rece desinsecting:
SPRAYED
Signed, if requerid

contained in this General Declararon, Agent ot
Pilot n Comand in any supplementary forms
the flight.
7.818.122-2
13.272.974-3
17.045.360-3
16.208.315-5
- 15.438.294-1
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Departure from :
TEMUCO
- CHILE
RICARDO COSTA FERRE1RA
FF568207
RODRIGO RODRGUEZ
CY274217
Arrival a t : SANTIAGO - CHILE


PEDRO GARCA - 15.170.594-4
Persons on board known to be suffering from illness other [han For offtCal USC only
airsickness or the effects of accidenls, as well as those cases of
illness disembarked during the flighl: . ,_.,_NONE
Anyotier condirtan-urrDoar'wich may leati lo tne spreaa ~of
disease:
NONE
Dctofls
ofIreatinunt
(place,date,tme,method) during the ftight. If no desinsecting has
been carried out the flight give rietalls of most recent desinsecting:
SPRAYED
Signed, f requerid.
Crew Member Con cerned

contained n this General Declaration, Agent ot
Pilot tn Comand n any supplernentary forms
passengers will continue/have continuad on
the flight.
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Date : 07 NOVIEMBRE 2013
Departure from :
TEMUCO - CHILE
ODRIGO RODRGUEZ
Arrival at:
SANTIAGO - CHILE
NUMBER OF PASSENGERS PASSPORT N(
FF568207
CY274217
illness disembarked during the flight: A/r.A/J-

HERNN ROSAS R. - 8.574.245-0

disease:
NONE
Detalls of each desinsecting r sanitary treatment
as been carried out the flight give detalls of most recent
jsinsecting:
SPRAYED

contained in thts General Declaration, Agent
OPERACIONES MATRICULA PRTAP AP. EL TEPUAL - PTO. MONTT

Fecha
04-08-2013
09-08-2013
02-09-2013
4
5
Aer
Vuelo
Acti
Reg
Matricula
A/D
XX
PRTAP
21:36
XX
PRTAP
XX
PRTAP
30-09-2013
02
19-10-2013
Q2
R/l
Ptataf
Fecha R / l
Dest
Aerova
Li
Is
21:31
SCEL
102
00:24
00:17
SCEL
36
22:52
22'47
SCEL
102
PRTAP
1655
16:50
SCPQ
267
PRTAP
14.35
14:28
SCNT
151
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
QwnerorOperator : TAXI AEREO PIRACICABA LTDA.
M A0 ' Zfl13
Marksof C-525
Departure from :
PTO. MONTT - CHILE
FF568207
RODRIGO RODRGUEZ
CY274217

PATRICIO STRAHOVSKY-5.712.575-6
AXEL
FGHT ROUTING PLACE
- CHILE
PICKETT - 7.818.122-2

CRISTIAN WARNER - 12.869.443
SHEILA GINICOLO - BRA

Persona on board known to be suffering from illnoss othor [han
airsicknoss or the effects of accidenls, as wel as thoso cases of
illness disembarkBd during the flight: ./n..c
Any othor condition on board wich may lead to tho spread of

clsense:
NONE
Dlais o eachdosinsecting o r s a i t a r y froatinent
(place.date.ttme.method) during the flight. If no desinsecting
has been carried out Ihe fliyhl givo detalla of mosl rccont
desinsocting:
SPRAYED
Signed, if requerid,.
Crow Mombnr Concerned

forms required to be presented wth this
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525
Departure from :
PTO. MONTT - CHILE

RODRIGO RODRGUEZ
Arrival a t :
SANTIAGO
- CHILE
FF568207
CY274217
PEC.IARATION OF HEALTH
Persons on board known to be suffenng froin illness other ttian
irsicknass or the offects of accidenta, as well as UIOSG cases of
illness disernbarKed duriny the flght:
MARCO ENRIQUEZ-O. -13.430.389-4

HERNN ROSAS - 8.574.245-0
ROSSANA MUOZ - 12.506.815-4
Any other condition on board wich rnay lead to the spread of

disease:
NONE
DetaEls o T e a c h deslnsecting or sanitary treatmenf
(place.date,time.method) during the flight, If no desinsecting
has been carried out the flight give detalis of most recent
desinsecting:
SPRAYED

all through passongors will continuo/have
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525
Departure from :
PTO . MONTT
- CHILE
FF568207
RODRIGO RODRGUEZ
CY274217
Persons on board known (o be sufferlng frum illness other than
arstcknoss or tho offocts of accdonls, as woll os those casos of
illness dfiombarked during the flght: A/nA,,=-
Arrivai a t ; SANTIAGO

WILLY GEISSE -7.072.361-1
PEDRO GARCA - 15.170.594-4
ANDRS TAPIA -10.966.492-8
Any othor condition on boord wich may load to the spread of

elsea se;
NONE
Detalls of each aesinsecting or sanitary troatmont

(place,date,timo,method) durtnp the fligh. If no desinsecting
has been carrid out the flght glvo detalls of most rece
osinsectinq:
SPRAYED
Signed, if requerid,.
Crow Member Concornod
I de ca red that alf staments and particulars

forms required to be presented wth this
General Declarationare complete, exact truo
all through passengers wll continu/nave
- CHILE
OPERACIONES MATRICULA PRTAP AD. PICHOY VALDIVIA

Fecha
Aer
Acti
Vuelo
Reg
Matricula
AiD
R/l
Plataf
26-07-205 3
XX
PRTAP
17:43
17:38
24-09-201 3
Q2
PRTAP
21:09
27-10-2013
02
PRTAP
22:41
07-11-2013
Q2
PRTAP
18.13
Fecha R / l
Des!.
Aerova
Is
Lz
SCTC
26
21:04
SCEL
20
22:32
SCEL
20
18:10
SCTC
26
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, GUSTOS, 1MMIGRATIONS, AND PUBLIC HEATH
Marks of C-525
Nationality and Registrations PP-TAU - - BRASIL
Date : 26 JULIO 2013
Departure from :
VALDIVIA - ;UIU.
TOTAL NUMBF.R OF CRFW

DRIGO RODRGUEZ
ArrivalM:
TEMUCO - CHILE
NUMBER OP PASENGERS PASSPORT N<
FFW58207
CY-'74?17
FLIGHT ROUTING PLACh
DECLARATION Ol~ HEALTH

Persons on board hii.iwn to bo ,;u<!; -\\\ liom iilt r . o ! , ihan
airsickness or the elfucts of accidenls. ;-is wct! as h <)" :^,t s of
llness disembarkRd <!.r,'~i, Ihe ftkjbl
f
,
VIARCO ENRIQUEZ O. -13.436.389-4

CARLOS DE URRESTI -14.025.579-3
FELIPE PIZAF<RO C. -16.163.532-4
HERNN ROSAS R. - 8.574.245-0
NONl-
Any other condttion on hoard wich m;iy lea;! !c ...

disease:
Detalls of encd rtismsr;olin(| nt

(place.date.time,mothnd) flurun h: li(|ht. !' <<->
JMS been carrt;tJ oi; liie fhcjht tvf ijf!(,i!!-. '^Bsnsecttng:
'
'
Signed, if requerid
I declared thai al) stainr.nl^ ir-.' ; ti-^

contained in th/s General Dcclaratton, Acjcnt
ot Pilot in Coiriinc in .:;n/ 3U|jj... ti'.itUry
forms requirecl to be presented with this
General Declarationare complolo, o-;.*c: rue
to the best of only my knowledgt. * n t tfiat
all through pii>sengers will con*'ti.io/nave
continued on tbe Hight
SIGNATURE AUTHFIZED
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Nationaty and Registrations PR-TAP - BRASIL
Departure from :
VALDIVIA
- CHILE

ODRIGO RODRGUEZ
- CHILE
FF568207
CY274217

PEDRO GARCA - 15.170.594-4
airsickness or the effects of accidents, as wel! as those cases of
illness disembarked during the flight: .,,,_
NONE
Any other condition on board wich may lead lo the spread of

disease:
NONE
Detals of each desinsecting or sanitary treatment
^fesinsecting:
^
SPRAYED

AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOWIS, IMIVIIGRATIONS, AND PUBLIC HEATH
Marks of C-525
Date; 27 OCTUBRE 2013
Departure from :
VALDIVIA
- CHILE
Arrival a t :
SANTIAGO - CHILE
COSTA FERREIRA FF568207

RODRIGO RODRGUEZ
CY274217

PEDRO GARCA - 15.170.594-4
Persona on board known to be suffering from Illness other than
illness disembarked during the flight: .,n.,p

disease;
NONE
Kletalls of each desnsecting or sanitary treatment
"place,date,time,method) during the flight. If no desinsecting
desinsecting;
SPRAYED

ail through passengers will continue/have
SiGNATURE AUTHORIZED
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Nationality and Registrations PR-TAP- BRASIL
Departure from :
VALDIVIA- CHILE

J^)DRIGO RODRGUEZ
Arrival at : TEMUCO
- CHILE
FF568207
CY274217
arsickness or the effects of accidents, as well as those cases of
illness disembarked during the flight: wr)WP

HERNN ROSAS R. - 8.574.245-0
EDGARDO BRUNA - 4. 498.633-7
DIEGO VARGAS - 16.848.937-4

disease:
NONE
Detalls of each desinsecting
or sanitary treatment
(place, date, time, method) during the flight. If no desinsecting
jas been carried out the flight give detalls of most recent
j^Knsecting:
^
SPRAYED
Signed, if requerid

OPERACIONES MATRICULA PRTAP AD. CAAL BAJO

Fecha
Aer
Vuelo
Acti
Reg
Matrcula
A/D
05-08-201 3
XX
PRTAP
16.58
06-08-201 3
XX
PRTAP
21-08-2013
XX
PRTAP
R/l
Plataf
Fecha R / I
Deat.
16.54
SCEL
21:59
21:53
22:29
22:27
Aerova
Is
Lz
102
SCEL
102
SCEL
98
AIR DISPATCH CHILE

GENERAL DECLARATION
(Qutward/lnward)
Owner or Operator ; TAXI AEREO PIRAC1CABA LTDA
Marks of C-525
Departure from : OSORNO - CHILE
FF568207
RODRIGO RODRGUEZ
CY274217
Arrival al
SANTIAGO - CHILE
ACFT SIN PAX
PECUARATIQN OFJHEALTH
PRrsona on board Nnown to be suflerinp. liom illness othei Ihan
aireickness or the effects of accidenta, as well as those cases of
illness disembatked dunng the flight , ,.,_
NONE
Any othet condltion on board wich may laad to the spread of
dsease
NONE
elalls oT eech dVsTnaectig oi sary fiâtmenl
(piace,dalfl.lime,melhod) dunng the flight II no desinsecting
has b?en carncd out !he flight gtve detalls of most fecent
desirtsecting
SPRAYED
Signed, if requerid

all through passengers wlll con ti n e/ha ve
For officlal use only
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Owner or Operalor : TAXI AEREO PIRACICABA LTDA.
Marksof C-525
Nationality and Registratons PR-TAP-BRASIL
Departure from :
OSORNO - CHILE

RICARDO COSTA
FERREIRA
RODRIGO RODRGUEZ
FF568207
CY274217
Persona on board known to be suflering from lineas olher (han
airsickness or Ihe effects of accidenis. as well as those cases of
illness disembarked durng Itie flight:
SCAR TAPIA O. -12.809.152-1

BENJAMN GALLARDO F- 17.727.931-5
PEDRO ABARCA C. - 9.463.645-0
FELIPE SNCHEZ Z. - 17.317.302-4
GLADY PALMA V. -6.384.372-5
CLAUDIA ULLOA P. - 19.205.598-1
Any olher condition on board wich may lead to Ihe spread o

disease
NONE
Detalls o( each desinsecling or sanitary trealmenl
(place,dale,lime.method) dur.ng the flicjhl. If no desinsecling
has been carried out Ihe flight give detalls of most recent
desinsecling
SPRAYEO
Signed, if requerid

AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525
Date: 21 AGOSTO
Departure from ;
OSORNO - CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
DECLARATIOH OF HEALTH
Persons on board known to ba sitfferlng from illr.ess othtjr than
airsickness or Ihe effects of accdenls, as wel! as Ihose cases of
illness disembarked during Ihe flighl:
Arrival a t :
SANTIAGO - CHILE

MARCO ENRIQUEZ O. -13,436.389-4
MIGUEL MRQUEZ - 6.307.980-4
MATAS NEGRETE - 13.457.805-K
HERNN ROSAS R. - 8.574.245-0
MARCOS FUENTES - 16.574.487-K

d'SeaSe
NONE
Detalls of eachdesinsecling or sanitary irealren

(place,date.time.melhod) during the flighl. If no desinsectinr)
has been carried out the flight give delalls of most recent
desinsecting.
SPRAYED
Signed, if requerid
Crew Memher Concerned

ot Pilot n Comand in any supplemcntary
2013
SIGNATURE AUTHORlZED
OPERACIONES MATRICULA PRTAP AD. MOCOPULLI - CASTRO

Fecha
Acti
Aer
Vuelo
Reg
Matricula
A/D
R/l
Pialar
Fecha R / 1
Dest.
Aerova
Lz
Is
30-09-2013
Q2
PRTAP
15:28
15.25
SCTE
30-09-2013
02
PRTAP
22:54
2250
SCEL
263
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Departurefrom:
DALCAHUE
- CHILE
ODRIGO RODRGUEZ
Arrival at:
PTO. MONTT
FF568207
CY274217
SIN PAX

disease:
NONE
(place,date,tme,method) during the flight. If no desinsecting
tas been carried out the flight give detalls of most recent
esinsecting:
SPRAYED
I deca red that all staments and parti u la rs

- CHILE
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marks of C-525
Departurefrom:
DALCAHUE
- CHILE
ODRIGO
RODRGUEZ
Arrival at: SANTIAGO
- CHILE
NUWIBER OF PASSENGERS PASSPORT N(
FF568207
CY274217

PEDRO GARCA - 15.170.594-4

disease:
NONE
Detalls of each deslnsecting or sanitary treatment
J-ias been carried out the flight give detalls of most recent
esinsecting:
w
SPRAYED

OPERACIONES MATRICULA PRTAP AD. MARA DOLORES - LOS ANGELES

Fecha
Aer
Acti
Vuelo
Reg
Matricula
A/D
R/!
Plataf
Fecha R! i
Dest.
Aerova
Is
Lz
31-08-2013
XX
PRTAP
21 58
21:55
SCEL
70
03-09-2013
XX
PRTAP
15:18
15:12
SCTC
02-10-2013
02
PRTAP
18:05
18:01
SCIE
26-10-2013
Q2
PRTAP
21:38
21:34
SCEL
39
OPERACIONES MATRICULA PRTAP AD. TTE. JULIO GALLARDO - PTO. NATALES

Fecha
20-10-2013
A
D
Acti
Aer
Q2
Vuelo
Reg
N
N
Matricula
PRTAP
AD
12:08
RM
Plataf
12:04
Fecha Rn
Dest.
SCCI
Lz
Aerova
249
Is
N
AIR D1SPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOMS, MMIGRATIONS, AND PUBLIC HEATH
Marks of C-525
Nationality and Registrations PR-TAP BRASIL
Departure from : PTO NATALES- CHILE
FF568207
RODRIGO RODRGUEZ
CY274217
Arrival a t : PTA ARENAS - CHILE
NUMBER OF PASSENGERS PASSPORT N D
Sin Pasajeros
DJECLAR ATIQN OF HEALTH

Persons on board known io be suffaring from lnoss ollier than
illrmss lisembarketl durlng trio flighl:
wr,j.fr
Any other condtion on board wich rnay lead to tho sproad of

diseasn'
WOWE
Detalls of each rlosinsectlng or sanitary troatmoni

(placo,<Jate,!me,mB(hoil) during the liyht. If no desnsocling
has been carred out tha flight glve detalla of most rucBnl
deslnsocting:
SPRAYED
f,"1
-'
Crew Mffmbcr Concerned
1 declared that all staments and particular^

contained in thls General Declaration, Agent
SIGNATURE AUTHOR1ZED
OPERACIONES MATRCULA PRTAP AD. GRALBDO. O'HIGGINS - CHILLAN

Fecha
Aer
21-07-2013
22-07-201 3
XX
09-09-2013
XX
16-09-2013
XX
04-10-2013
02
11-11-2013
Q2
XX
Acti
Vuelo
Reg
Matricula
AID
R/l
Plataf
Fecha R / 1
Dest.
PRTAP
PRTAP
PRTAP
PRTAP
22:36
22:34
PRTAP
22:10
22:08
fl
PRTAP
20:05
20:03
SCEL
22:22
Aerova
Is
Lz
22:20
SCEL
70
19:48
19:46
SCEL
70
22:48
22:46
SCEL
70
SCEL
SCEL
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
Marksof C-525
Nationaliiy and Registrations PR-TAP - BRASIL
Departure from :
CHILLAN
- CHILE

FF568207
RODRIGO RODRGUEZ
CY274217
Arriva) a t :
SANTIAGO
- CHILE
KAREN DOGGENWEILLER - 10.354,902-7

PEDRO GARCA - 15.170.594-4
EVELYN TAPIA - 15.514.537^4
Persons on board known to be suffenng from iflness olher than
alrsickness or the effects of accidents, as wetl as those cases of
tllness disembarked clurng the flight:
Any olher condition on boarc wtch may fead to the spread of

disease:
NONE
D e t a J I s o eoch desirmectingor sanitary tteatment
(placc,datc,tinie,mcthod) duiing the flight If no desmaecting
has been carned out the flight give detalls of most rece
dosinsecting
PRAYLD
Signed, if requerid
Crnw iwemfaer Coacerned
I dcctared that all staments and particulars

contained In this General Dcclaratlon, Agent
forms required to be presented wlth this
all through passengcrs will continue/have
2013
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOMS, IMMIGRATiONS, AND PUBLIC HEATH
Marks of C-525
Departurefrom :
CHILLAN
- CHILE
Arrival at : SANTIAGO

FF568207
RODRIGO RODRGUEZ
CY274217
- CHILE

PEDRO GARCA - 15.170.594-4
Persone on board known lo he suffering (rom itlnoss ollinr ttum
illness disembarked during the flight: . ,n.,r
Any other condition on board wich may leyd lo the spreacl of

disease.
NONE

(place,date,time.melhod) durny Ihc flight. If no desinsecting
has been carned oul the flighl givf? deUills nf most recent
desinsecting;
I
SPRAYED

all through passengers will continuo/nave
SIGNATURE AUTHORIZtD
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/inward)
AGRICULTURE, CUSTOIVIS, IMM1GRATIONS, AND PUBLIC HEATH
Owner or Operator : TAXI AEREO PiRACICABA LTDA.
Marks of C-525
Date : 04 OCTUBRE
Departurefrom:
CHILLAN
- CHILE
Arrival at:
2013
SANTIAGO - CHILE
FF568207
RODRGUEZ
CY274217
Persons on board known lo he suffering frorn illnoss olhr han
aifsickness or tfie elfects of accidents, as wetl as those cases of
illness disembarked during the fiight

PEDRO GARCA - 15.170.594-4

Any other condition on boord wich may lead to the sprcad of

NONH
Detalls o e a c h d e s i n s e c i n g or sanitary treatment
(placo.date.time.method) during the fltght. If no dcsinscctmg
has been canied out the flight give detalls o tnos recent
csinsccting.
SPRAYED
Signed, if requerid
Crew Mfimbcr ConcBned
I de ca red that all staments and particulars

contamed in this General Declaration, Agcnt
to the best of only my knowlodgo and that
all through passongors will contmue/have
AIR DISPATCH CHILE

GENERAL DECLARATION
(Outward/lnward)
AGRICULTURE, CUSTOMS, IMMIGRATiONS, AND PUBLIC HEATH
Marksof C-525
Nationality and Regisrations PR-TAP-BRASIL
Departure from :
CHILLAN - CHILE
Arrival at:
SANTIAGO
- CHILE
FF568207
IODRIGO RODRGUEZ
CYZ74217
CARLOS OMINAMI - 5.470.78-2
Porsons on board known to be suffering from illness olhei than
airsickness or the effects of accidents, iis wetl as Ihose cases of
illness disembarked during the flight: ./rwp
Any other condition on board wch inay lead to the spiead of

disoaso:
WOA/5
Dctalls of each desinsectiny or SHiiitaiy tieolment
(place,dalo,lime,me(hod) during tho flighl. l no dnsinsecting
Mas been carriod out the fiigiii give delalls of most recent
sinsecting:
SPRAYED
Crew Membei Concerned

forms requirod to be presented with this
al! through passengers will continue/have
SIGNATURE AUTHORIZBD

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DIRECCIN GENERAL DE AERONUTICA CIVIL

D.G.A.C. Of. N Q5/0/

OBJ.: Complementa informacin sobre

DIRECCIN GENERAL DE AERONUTICA CIVIL

Mediante oficio de la referencia 1) esta Direccin General

Sobre el particular y en cumplimiento del compromiso

anloga informacin a la demandada por esa H. Cmara, actuaciones que

1.- H. Camarade Diputados *

OPERACIONES MATRCULA PRTAP AP.CHACALLUTA - ARICA

AIR D1SPATCH CHILE

TOTAL NUMBER OF CRfEW

RICARDO COSTA FERREIRA

NUMBER OF PASSENGERS PASSPORT N"

MARCO ENRIQUE^ O. - 13.436.389-4

JAIME PARADA -13.272.974-3

FOT Official USO OMly

Auy olhfr condilion on honrd wich nui^ Inart tu '':c

lllni;t;.(]^lt'.(ime.Hie!U)d) dunnq llv; flirjhl if no 'Jcsirisf.'<.1.piu

I declarcd that afl staments and partculars

AIR DISPATCH CHILE

TAXI AEREO PIRACICABA LTDA

TOTAL NUMBER OF CREW

RICARDO COSTA FERREIRA

NUMBER OF PASSENGERS PASSPORT N"

FLIGHT ROUTING PLACE

(place (l.iie.lim! melhod) dirrtng the Hi^tti II no tpitnspclun]

I declared that al) staments and particulars

contnucd on the ffight.

AIR D1SPATCH CHILb

TOTAL NUMBER OF CREW

KAREN DOGGENWEILLER - 10.354.902-7

FLIGHT ROUTING PLACE

For official uso only

o eati desmsi'cti'H) o< sflmtafy iif^Mic

contained jn this General Declaration, Agcnt

AIR DISPATCH CHILE

TOTAL NUMBER OF CREW

NUMBER OF PASSENGERS PASSPORT

RICARDO COSTA FERREIRA FF568207

MARCO ENRIQUEZ O. - 13.436.389-4

FELIPE PIZARRO - 16.163.532-4

MARCOS ORTIZ - 10.079.303-2

FLIGHT ROUTING PLACE

For offtcial uso only

o "ocfi 3psiseciri o<

I de el a red that all staments and parliculars

OPERACIONES MATRICULA PRTAP AP. DIEGO ARACENA - IQUIQUE

AIR DISPATCH CHILE

FLIGHT ROUTING PLACE

Arrival at: ARICA - CHILE

MARCO ENRIQUEZ O. -13.436.389-4

Por otficial use only

Any olher condilion on board wich may lead to the spread of

1 declarad that all staments and particulars

TOTAL NUMBER OF CREW

Arrival at : SANTIAGO - CHILE

NUMBER OF PASSENGERS PASSPORT N

RICARDO COSTA FERREIRA

ACFT SIN PAX

FLIGHT ROUTING PLACE

For official use only

Any olher condition on board wich may lead lo the spread of

I declared that all staments and particulars

AIR DISPATCH CHILE