I hereby declare that the information provided is true and correct. I understand that the decision on my application will be decided by the Ministry of Health. Any false information provided us an offence under Section 22(d) of the Prevention and Control of Infectious Diseases Act. 1988 (Act 342), and if convicted, is punishable under Section 24 of the same Act. If applicant is found to provide false information, approval will be automatically revoked.