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GENERAL DECLARATION (Outward/Inward) AGRICULTURE, CUSTOMS, IMMIGRATION, AND PUBLIC HEALTH NATIONAL AERONAUTICS AND SPACE ADMINISTRATION Owner or Operator Flight APOLLO 11 No. . Marks of Nationality and Registration U.S.A JULY 24, 1969 Date.. MOON HONOLULU HAWAII U.S.A (Place and Country) Departure from Arrival at (Place and Country) FLIGHT ROUTING ("Place" Column always to list origin, every en-route stop and destination) TOTAL NUMBER NUMBER OF PASSENGERS ON THIS STAGE PLACE OF CREW CARGO COMMANDER NEIL A ARMSTRONG CAPE KENNEDY MOON Departure Place: MOON ROCK AND NIL Embarking MOON DUST COLONEL EDWIN E. ALDRIN, JR JULY 24, 1969 HONOLULU Through on same flight NIL SAMPLES Cergo Manifests Attached Arrival Place: NIL Disembarking Through on same flight NIL LT. COLONEL MICHAEL COLLINS For official use only Declaration of Health Persons on board known to be suffering from illness other than airsiekness or the effects of accidents, as well as those cases of illness disembarked during the flight: NONE HONOLULU AIRPORT Honolulu, Hawaii ENTERED Any other condition on board which may lead to the spread of disease: TO BE DETERMINED Customs Inspector Details of each disinsecting or sanitary treatment (place, date, time, method) during the flight. If no disinseeting has been earried out during the flight give details of most recent disinsecting: Signed, if required Crew Member Concerned I declare that all statements and partieulars contained in this General Declaration, and in any supplementary forms required to be presented with this General Declaration are complete, exact and true to the best of my knowledge and that all through passengers will continue/have continued on the flight.

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ELEMENT JUST ALK IOTS HERE H NEW YORK LICENSE PLATE EXCELSIOR 4WD

R HOT FROM CONCENTRATE FREE GLUTEN FREE ADDED SUGAR Total Fat Saturated Fat Cholectar Sodium

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Mildly Interesting - When the Apollo 11 astronauts landed in the sea, they were brought to Hawaii. They were required to ...

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GENERAL DECLARATION (Outward/Inward) AGRICULTURE, CUSTOMS, IMMIGRATION, AND PUBLIC HEALTH NATIONAL AERONAUTICS AND SPACE ADMINISTRATION Owner or Operator Flight APOLLO 11 No. . Marks of Nationality and Registration U.S.A JULY 24, 1969 Date.. MOON HONOLULU HAWAII U.S.A (Place and Country) Departure from Arrival at (Place and Country) FLIGHT ROUTING ("Place" Column always to list origin, every en-route stop and destination) TOTAL NUMBER NUMBER OF PASSENGERS ON THIS STAGE PLACE OF CREW CARGO COMMANDER NEIL A ARMSTRONG CAPE KENNEDY MOON Departure Place: MOON ROCK AND NIL Embarking MOON DUST COLONEL EDWIN E. ALDRIN, JR JULY 24, 1969 HONOLULU Through on same flight NIL SAMPLES Cergo Manifests Attached Arrival Place: NIL Disembarking Through on same flight NIL LT. COLONEL MICHAEL COLLINS For official use only Declaration of Health Persons on board known to be suffering from illness other than airsiekness or the effects of accidents, as well as those cases of illness disembarked during the flight: NONE HONOLULU AIRPORT Honolulu, Hawaii ENTERED Any other condition on board which may lead to the spread of disease: TO BE DETERMINED Customs Inspector Details of each disinsecting or sanitary treatment (place, date, time, method) during the flight. If no disinseeting has been earried out during the flight give details of most recent disinsecting: Signed, if required Crew Member Concerned I declare that all statements and partieulars contained in this General Declaration, and in any supplementary forms required to be presented with this General Declaration are complete, exact and true to the best of my knowledge and that all through passengers will continue/have continued on the flight.

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