COVID19: Nagaland

Self Declaration Form

Please Fill up the Form below.

On successfull Submission you can download your Form and show it at the Point of Entry

Aircraft / Train / Car No.

Name

Mobile No.

Destination State

Destination District

Transit Passenger(Inter State)?

Residential address

Residential proof

Identity proof

I hereby declare that

Please select whichever is applicable

I have a Negative COVID-19 test report by RT-PCR/ Truenat/ CBNAAT, with the test done not earlier than 72(seventy two) hours prior to entry into Nagaland and I shall self isolate/remain in quarantine, for 7 (seven) days.

I do not have a Negative COVID-19 test report and I shall self/isolate/quarantine for 7 (seven) days.

I am a transit passenger (inter-state) to and I shall proceed to my destination without halting anywhere in Nagaland, and I am adhering to the testing guidelines of State.

The information provided by me is true and correct to the best of my knowledge and belief. In the event of any information given is found to be false or incorrect, I shall be responsible for the consequences.

I am aware that in case of violation of the Government instructions, or the undertaking given by me, I shall be liable to be prosecuted as per law.

**This is a system generated Self Declaration Form and does not require a signature.