UK Visas & Immigration: Personal Information [PDF]

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UK Visas & Immigration NAME:

Dan Andrei Scutelnicu

PASSPORT NUMBER:

056985781

DATE OF SUBMISSION:

26 July 2020 10:44 British Summer Time (BST)

FORM:

Public Health Passenger Locator Form

REFERENCE:

5ZAA015949139

REGISTRATION EMAIL:

[email protected]

Personal information Email address

[email protected]

Travel information Do you know where you will stay for your first 14 days in the UK?

Yes

What address will you stay at for your first 14 days in the UK?

33 St Peters Avenue Northants Kettering NN16 0HB

When will you arrive there?

27 July 2020

When will you leave there?

10 August 2020

Are you exempt from self-isolating for the first 14 days you are in the UK?

No

Will you be travelling to the UK as part of an organised group?

No

What are your travel plans?

Stay in the UK

Where will you arrive in the UK?

Luton Airport

What country are you travelling from?

Romania

Which operator will you be travelling with?

WizzAir

What are the booking reference(s) for your travel?

RJQF7E

What is the flight number, train service or ship name that you will arrive on?

W63301

Dan Andrei Scutelnicu

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UK Visas & Immigration What is your seat number? (if relevant)

1D

Which countries have you been in, or will you be in, Romania for the 14 days before coming to the UK? Arrival date

2 June 2020

Departure date

27 July 2020

Your planned travel information When do you plan to arrive in the UK?

27 July 2020 09:30 AM

When do you plan to leave the UK? (optional)

27 October 2020

Personal information Are you completing this form for someone else?

No

Given name(s)

Dan Andrei

Family name

Scutelnicu

Are you now or have you ever been known by another name?

No

What is your sex?

Male

Residential address

Sergent Hategan bl. B7, ap.11 Aiud Alba 515200 Romania

Provide your telephone number

0040747276699

Where do you use this telephone number?

For use whilst in the UK For use whilst out of the UK

Select whether this is your home, mobile or work telephone number

Mobile telephone number

Provide your telephone number

447392751207

Where do you use this telephone number?

For use whilst in the UK

Select whether this is your home, mobile or work

Business telephone number

Dan Andrei Scutelnicu

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UK Visas & Immigration telephone number Are you able to be contacted by telephone?

I can be contacted by telephone call and text message (SMS)

What is your preferred contact number?

0040747276699

Date of birth

23 May 1984

Passport details Passport number or travel document reference number

056985781

Issuing authority

Alba

Issue date

12 February 2019

Expiry date

12 February 2029

People you are travelling with Are you travelling to the UK with anyone under 18 years old, that you are including on this form?

No

Emergency contact Their name

Taielup Adrian

Their telephone number

07784730748

Their email address

[email protected]

Declaration I declare that: I will arrive in the UK within the next 48 hours the information I have entered in this form is correct

I confirm that I understand and agree with the above declarations.

Dan Andrei Scutelnicu

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