Passenger Locator Form

STATUS: NON-RED LIST

VACCINE STATUS: VERIFIED FULL/EXEMPT

The code contains personal

information. By sharing the code,
you will be sharing your passenger
locator form data.

Summary
Name Constantin Stanciu
Passport number 057815062
Which company are you travelling with? Wizz Air
What is the flight number, train number or ship W63753
name that you will arrive on?
Reference UKVI_5ZAA033600616
Status NON-RED LIST
Arrival location London Luton Airport (LTN)
Date of arrival 13 February 2022 09:00 Greenwich Mean Time
(GMT)
Date of submission 11 February 2022 09:20 Greenwich Mean Time
(GMT)

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Personal information

Email address cosmin.raoul.stanciu@gmail.com

Travel information

Do you have an address for where you will stay Yes

during your first 10 days in the UK?

You provided the following address as your Yes

residential address. Do you plan on staying at this
address?
10 ALBANY ROAD
HORNCHURCH
RM124AF

What address will you stay at for your first 10 days 10 ALBANY ROAD
in the UK? HORNCHURCH
RM124AF

When will you arrive there? 13 February 2022

When will you leave there? 30 June 2022

Where will you arrive in the UK? London Luton Airport (LTN)

What country or territory are you travelling from? Romania

Which company are you travelling with? Wizz Air

What is the flight number, train number or ship W63753

name that you will arrive on?

Your cabin type or your coach number Aircraft - Economy

Which countries or territories have you been in, or Romania

will you be in, for the 10 days before coming to the
UK?

Did you transit through this country or territory via No

plane or train without passing Border Control?

Have you visited, or will you visit, any islands in this No

country or territory during the 10 days before you
arrive in the UK?

Arrival date (optional) 12 December 2021

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Departure date 13 February 2022

Your dates of travel

Which date do you plan to arrive in the UK? 13 February 2022 09:00 AM

Personal information

Given name(s) Constantin

Family name / Surname Stanciu

What is your sex? Male

Is your home address in the UK? Yes

Home address 10 ALBANY ROAD

HORNCHURCH
RM124AF
(address verified)

How can we contact you when you are in the UK? I can be contacted by phone call and text message
(SMS)

Date of birth 29 May 1983

Your primary phone number +44 7746146859

Do you meet the COVID-19 vaccination eligibility Yes

criteria for reduced isolation and testing
requirements?

Do you have a QR code that you can use to verify Yes

your vaccination status?

How would you like to provide proof of your Attach a file or screenshot containing a QR code
vaccination status?

Have you provided proof of your vaccination Yes

status?

How do you meet the COVID-19 vaccination status I am fully vaccinated by a recognised programme
eligibility requirements?

Which country or territory did you receive your Romania

COVID-19 vaccination(s) in?

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Passport and travel document details

Passport number or travel document reference 057815062

number

Country or territory of issue Romania (ROU)

Expiry date 24 July 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?

Declaration
I declare that:

I understand I have to provide proof of my negative PCR or LFD coronavirus (COVID-19) test result, unless
I am exempt or meet vaccine eligibility criteria
I understand that I must bring proof of my COVID-19 vaccination status if I meet the eligibility criteria. My
proof of vaccination status (if declared) contains my full name, date of birth, vaccine brand and
manufacturer, the dates for all my vaccination doses and the country of vaccination and/or certificate
issuer
The information I have entered in this form is correct
I understand it could be a criminal offence to provide false details and I may be prosecuted

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

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