UK Visas & Immigration

NAME: Constantin-Lorin Stuparu

PASSPORT NUMBER: 056988162
DATE OF SUBMISSION: 03 September 2020 15:05 British Summer Time
(BST)
FORM: Public Health Passenger Locator Form
REFERENCE: 5ZAA019659336
REGISTRATION EMAIL: lorianstuparu3@gmail.com

Personal information

Email address lorianstuparu3@gmail.com

Travel information

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

What address will you stay at for your first 14 days Aps Produce Main Road Hale Common
in the UK? Arreton
Isle of Wight
New Port
PO30 3AR

When will you arrive there? 5 September 2020

When will you leave there? 20 September 2020

Are you exempt from self-isolating for the first 14 No

days you are in the UK?

Will you be travelling to the UK as part of an No

organised group?

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 UK Visas & Immigration
What are your travel plans? Stay in the UK

Where will you arrive in the UK? Aps Produce Main Road Hale Common Arreton Isle
of Wight

What country are you travelling from? Romania

Which operator will you be travelling with? Madalin Barbulescu

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

What is the flight number, train service or ship i dont know

name that you will arrive on?

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

Arrival date 5 September 2020

Departure date 5 September 2020

Your planned travel information

When do you plan to arrive in the UK? 5 September 2020 08:30 AM

Personal information

Are you completing this form for someone else? No

Given name(s) Constantin-Lorin

Family name Stuparu

Are you now or have you ever been known by No

another name?

What is your sex? Male

Residential address Wight Salads Nursery,Hale Common, Arreton

New Port
Arreton
PO303AR
United Kingdom of Great Britain and Northern
Ireland

Are you able to be contacted by telephone? I cannot be contacted by telephone call or text
message (SMS)

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 UK Visas & Immigration
Explain why you cannot be contacted by telephone I DONT SPEAK ENGLISH
call or text message (SMS)

Date of birth 22 August 1997

Provide your telephone number +44 07547268915

Where do you use this telephone number? For use whilst in the UK

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

Passport details

Passport number or travel document reference 056988162

number

Issuing authority Romania

Issue date 13 February 2019

Expiry date 13 February 2029

People you are travelling with

Are you travelling to the UK with anyone under 18 No

years old, that you are including on this form?

Emergency contact

Their name Dinca Alexandru

Their telephone number 0768006053

Their email address alex_craiova23@yahoo.com

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 have given permission to receive a copy of my form via email

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

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