CONFIDENTIAL

SPECIMEN FORM K29

M

(UNDERTAKING TO REPAY)

ANNEX D TO

JTP 1

(9TH REVISE)

GROUP TRAVEL

UNDERTAKING TO REPAY

To be filled in before departure

This form must be completed in full before embarkation by each head of family, or person travelling separately, and return to the issuing office or officer before embarkation will be permitted.

PART A.

1.

Surname (Block letters)

Sex

Forenames

Date of Birth

Nationality/citizenship

Place of Birth

2. Accompanied by:

Name | Sex | Date of Birth Place of Birth Relationship

3.

Address in the UK and/or future address to which correspondence can be sent

4.

Last address in country from which departing

5.

Name and address of next of kin

6.

Name and address of employer (1)

Note:

1. If two or more employees of the same employer are being evacuated at the same time the employer is required to complete a 'Group Undertaking to Repay' covering all employees, and their dependants, being evacuated.

D-1

CONFIDENTIAL

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