NAME: PASSPORT NUMBER: DATE OF SUBMISSION: FORM: REFERENCE REGISTRATION EMAIL: Have you visited a Red List country within the last 10 days and are required to quarantine in @ ‘government approved facility? UK Visas & Immigration ALEXANDRU BARBACARU 058475747 414 February 2021 15:32 Greenwich Mean Time (emt) Public Health Passenger Locator Form ‘UKVL_SZAA002778484 alex_rombar@lve.com No Personal information Emall address alex_rombar@Uve.com Travel information Do you need to settisolate when you arriv UK? No, | am travelling for work and my job is exempt What type of job are you travelling for? ‘Seasonal agricultural workers What are your travel plans? Stay in the UK Which countries have you been in, or will you be in, Romania for the 10 days before coming to the UK? Arrival date Departure date 46 February 2021 ~ Pils Seccric “A dog serena auzt ~Dadh plain Ro Where will you arrive in the UK? What country are you travelling from? ALEXANDRU BARBACARU unron — & canpledeana, Dever deat alitonf ¢ nec fetus Romania Page | of 3B UK Visas & Immigration Which operator will you be traveling with? ‘What is the flight number, train service or ship ‘name that you will ative on? What is your seat number? (you must provide your seat number if relevant. Include coach number if travelling by train, for example coach 5 seat 2) WZAR = conptuta cx ce eclirife We3001 - Ausulr Ror Sue ctalicor 5 - muteit toe th civinw Sta aucat Your planned travel information When do you plan to arrive in the UK? When do you plan to leave the UK? (optional) ‘Fobra 2021 o6c00 aM = Delile ainve dn Cf(aice) 4eMarch 2021 ~ (ycl salute aE a toler? oy Personal information ane Given name(s) ALEXANDRU Family name BARBACARU Whats your sex? Male Is your home address in the UK? Yes Home address STAPLES VEGETABLESLTD ~ clita fleyce wile MARSH FARM SEA LANE, WRANGLE BOSTON PE22 SHE (address verted) Are you able tobe contacted by telephone? ean be contacted by telephone call and text message (SMS) Date of birth 5 May 1975 Provide your primary telephone number +40 744967473 Passport detail Passport number or travel document reference 058475747 number County of ssue Romania (ROM) Issue date 14 January 2020 ALEXANDRU BARBACARU Page 2083e UK Visas & Immigration Expiry date 14 January 2030 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 | dectare that: ‘© Lwill arrive inthe UK within the next 48 hours ‘© understand | have to provide proof ofa negative COVIO 19 test prior to departure to the UK (unless have provided my seat number, if relevant ‘The information | have entered in this form is correct It any of your information changes once you have submitted your details, such as travel detals, seat number, or Contact information, you must complete a new form, | confirm that | understand and agree with the above declarations. ‘ALEXANDRU BARBACARU Page 3 of 3