Dear Guest,

Following the instructions of Greek Ministry of Tourism and Greek Ministry of Health (1881/30.5.2020), the
accommodation must keep a record of all guests for the purposes of public health protection, so that it is possible to
communicate with these people in the case of any COVID-19 incident.

PERSONAL INFORMATION
NAME Vrana
SURNAME Nicolae -Adrian
NATIONALITY Rumanien
SEX Male
DATE OF BIRHT 30.04.1985
HOME ADREESS Strada Crizantemelor
TELEPHONE NUMBER 0750850501
E-MAIL Ioanamarian90@yahoo.com
EMERGENCY CONTACT DETAILS Iordache ghinea elena
(name, contact number) 0744750123
TRAVEL INFORMATION
ARRIVAL DATE 14.06.2021
DEPARTURE DATE 21.06.2021
NUMBER OF TRAVEL COMPANIONS 2
OR FAMILY MEMBERS
MEANS OF TRANSPORTATION TO DESTINATION
AIR PLANE
BOAT
Yes
IF YOU TRAVEL BY AIRPLANE, PLEASE FILL THE FOLLOWING INFORMATION
LANDING AIRPORT
AIRLINE COMPANY
FLIGHT NUMBER (ARRIVAL)
ARRIVAL TIME

IF YOU TRAVEL BY BOAT, PLEASE FILL THE FOLLOWING INFORMATION

SHIPPING COMPANY Anek
BOAT NAME Anek
ARRIVAL PORT Piraues
DEPARTURE PORT Heraklion
ARRIVAL DATE (ON DESTINATION) 14 06.2021

I have not experienced none of the following symptoms such as fever, cough, sore throat, runny nose , sudden
shortness of breath or diarrhea, nausea, vomiting, myalgia, within the last 14 days and or I have not been in direct
contact with a confirmed or suspected COVID-19 patient within the last 14 days and or I have not visited and/or
needed inpatient treatment in any healthcare facility and or confinement facility used for the treatment or
quarantine of COVID-19 confirmed or suspected persons within the last 14 days.

I declare under penalty of perjury under the laws of the Greek Republic that the facts and information I have
provided, including my travel companions/family members (if any) under 18, are true.

Full Name: vrana nicolae Date: …09.…/…06…/2021

Signature: