I hereby declare, under penalty of law,  that I or persons whom I reside with that have not displayed any symptoms such as cough, sore throat, fever, or been in contact with a confirmed COVID-19 case in the past 14 days.
本人特此聲明，自本日起過去14天內，我或我同住的親友沒有出現任何不適症狀，例如咳嗽，喉嚨痛，發燒，或沒有接觸確診2019 新型冠狀病毒之病例。