Passenger Locator Form

STATUS: AMBER
VACCINE STATUS: NO/NOT DECLARED

The code contains personal

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

Summary
Name Ayaan garg
Passport number U2958408
Which company are you travelling with? British Airways plc
What is the flight number, train service or ship BA 256
name that you will arrive on?
Reference UKVI_5ZAA010321686
Status AMB
What are your travel plans? Stay in the UK
Are you required to self-isolate when you arrive in I need to self-isolate when I arrive in the UK,
the UK? unless I was fully vaccinated in the UK or under a
vaccine programme approved by the UK or I have
only been in green list countries or islands
Are you required to book a COVID-19 test Yes
package for when you arrive in the UK?
Covid test booking reference ONCOL1955712
Test to release provider n/a
Arrival location London Heathrow Airport (LHR)
Date of arrival 18 August 2021 13:20 British Summer Time (BST)
Date of submission 17 August 2021 18:42 British Summer Time (BST)

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Personal information

Email address yograjgarg@gmail.com

Travel information

Do you have an address for where you will stay Yes

during your first 10 days in the UK?

Who are you planning to stay with in the UK? another persons home

What address will you stay at for your first 10 days 9 DEVONSHIRE PLACE
in the UK? First Floor Flat
BRIGHTON
BN2 1QA

When will you arrive there? 18 August 2021

When will you leave there? 15 August 2023

Are you required to self-isolate when you arrive in I need to self-isolate when I arrive in the UK, unless I
the UK? was fully vaccinated in the UK or under a vaccine
programme approved by the UK or I have only been
in green list countries or islands

What are your travel plans? Stay in the UK

Where will you arrive in the UK? London Heathrow Airport (LHR)

What country are you travelling from? India

Which company are you travelling with? British Airways plc

What is the flight number, train service or ship BA 256

name that you will arrive on?

What is your seat number? (you must provide your 32C

seat number if relevant. Include coach number if
travelling by train, for example coach 5 seat 2)

Which countries have you been in, or will you be in, India
for the 10 days before coming to the UK?

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

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

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Departure date 18 August 2021

Your dates of travel

When do you plan to arrive in the UK? 18 August 2021 13:20 PM

When do you plan to leave the UK? (optional) 15 August 2023

Personal information

Given name(s) Ayaan

Family name garg

What is your sex? Male

Is your home address in the UK? No

Home address A-65, Ground Floor

Sector 15
Noida
Noida
UP
201301
India

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 1 October 2014

Your primary phone number +91 9582945175

Your secondary phone number (optional) +91 8588877225

Do you meet the COVID-19 vaccination eligibility No/Prefer not to say

criteria for reduced isolation and testing
requirements?

Passport and travel document details

Passport number or travel document reference U2958408

number

Country of Issue India (IND)

Expiry date 29 March 2026

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 UK Visas & Immigration
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 will arrive in the UK within the next 48 hours

I understand I have to provide proof of a negative COVID-19 test prior to departure to the UK (unless I am
exempt)
I understand that I must bring proof of my COVID-19 vaccination status if I meet the eligibility criteria
I have provided my seat number, if relevant
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

If any of your information changes once you have submitted your form, such as travel details, seat number, or
contact information, you must complete a new form.

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

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