Passenger Locator Form

You are required to carry your vaccination certificate to be allowed by the border authorities to enter the country.

1. Personal
. . . . . . . Information -··············-······-·······-·······-······-·······-······-·

Last Name / Middle / First Name Sex / Age

Fromont / - / Elsa Female / 37

Mobile Phone Number Business Phone Number Home Phone Number

Unique Code
+33682866873 - -
4195669236
Other Phone Number Email Passport
Date Submitted
- elsafromont@gmail.com 14DE71681
2021-08-14

1. .Transportation
.... Information: Aircraft Flight Information
Airline name Flight number

Air France AF1002

Date of arrival Point of Entry in the Country

2021-08-15 Heraklion

Connection Flight Information

Airline name Flight number Date of arrival

- - -

I Permanent Address
--------
Country State / Province City

France Ile-de-France Le Plessis Trevise

Street (Name, Number, ZIP) Apartment Number / Previously Visited Country

Cabin Number
Avenue lefevre 35 94420 -

1 Temporary
..... Address --------------------------------------------------------------------------------------
Country State / Province City

Greece - Elounda

Street (Name, Number, ZIP) Hotel Name (If Any) / Apartment Number / Cabin
Cruise Ship Name Number
Agia paraskevi 72053 Elounda blu -
 Passenger Locator Form

1. .Secondary
. . . . . . . . . . . . . . . . .Temporary
. . . . . . . . . . . . . . . . .Address
..........................................................
Country State / Province City

Street (Name, Number, ZIP) Hotel Name (If Any) / Cruise Apartment Number /
Ship Name Cabin Number

1. .Emergency
. . . . . . . . . . . . . . . . . .Contact
. . . . . . . . . . . . Information
..............................................................
Last (Family) Name First (Given) Name Country / City

Fromont Francis France / Gretz

Armainviliers
Mobile Phone Number Other Phone Number Email
+33670034763 - francisfromont77@gmail.c
om

1. . Travel
. . . . . . . . . . Companions
. . . . . . . . . . . . . . . . . . . . –. . .Family
...........................................................
Number Last Name / First Name / Passport / ID Age Seat Number

1. . .Travel
. . . . . . . . . .Companions
. . . . . . . . . . . . . . . . . . . .–. . Non-Family
. . . . . . . . . . . . . . . . . ./. .Non-Same
. . . . . . . . . . . . . . . .Household
.......................
Number Last Name / First Name / Passport / ID Group (Tour, Team, Business, Other)

1. . .Digital
. . . . . . . . . . Certificate
.................................................................................
First Name Last Name Passport / ID Number Expiration

Elsa Fromont -/ - -

Type Manufacturer Country Certificate ID

Other Digital / Non Pfizer BioNtech France -
Digital