Quarantine Plan 
Primary Contact Information 
Date of 
Full Name: PUNEET KUMAR Birth: 1996/09/19  (YYYY/MM/DD) 

Address: WARD NO. 3, H. NO. 31 B, NEAR DURGA MANDIR ROAD, MANDI DABWALI Street Address 
,INDIA 

MANDI DABWALI HARYANA 125104 City Province Postal Code 

Phone: +918708128346 Email: puneetrajouria@gmail.com 

 

Travel Information 
YES NO 
Are there any additional travelers in your group? (If YES, each traveler should fill out their own form) 

Arrival Date: 22nd APRIL 2021 Airport of Arrival and Terminal: TORONTO,TERMINAL 1 LESTER
B PEARSON INTERNATIONAL 

AIR SEA GROUND TRANSPORTATION 

Arrival by? 

Airline / Flight Number (if applicable): AIR INDIA / AI -187 

Passport Document Number: R5003100 

Quarantine Plan 

Do you have accommodations where you can quarantine for 14 days? 

YES NO 

If “YES”, 
quarantine 
type?: 

If “YES”, what is the address where you 

PRIVATE 
RESIDENCE 
WITH 
FAMILY 
COMMERCIAL  (HOTEL) 
UNIVERSITY 
RESIDENCE OTHER 

will be staying: ALT HOTEL TORONTO AIRPORT 6080,VISCOUNT

ROAD,  Hotel Name Street Address  
MISSISSAUGA ONTARIO 

Do you need accommodation assistance to quarantine from anyone who is over 65 years old or who has heart
disease, high blood pressure, asthma or other lung disease, diabetes, cancer, immune suppression or is taking
prednisone medication? 
YES NO In 

Page 1 of 2 
Are you able to make the necessary arrangements for your quarantine
period? (e.g. food, medication, childcare, cleaning supplies, pet care) YES NO 

If “YES”, how will you 

receive these necessities?DELIVERY MEAL PLAN 
FRIENDS/ FAMILY 
TO PROVIDE OTHER 

What form of transportation will you take to your quarantine location? (optional) 
PRIVATE 
TRANSPORTATION 
PUBLIC 
TRANSPORTATION 
TAXI OR RIDE SHARE 

Additional Information 
 If you have any other details that you would like to include for your quarantine plan, please add them here.
My quarantine plan includes initial 3 days stay in Alt hotel Toronto Airport as I mentioned above
however, I will sta  
remaining 11 days in a private room with separate washroom at 88 Baylawn Circle, L6P

2M5, Brampton,ON. Also, I am attaching booking confirmation receipt of Alt Hotel

Toronto as a proof of my quarantine 

plan.  

Disclaimer and Signature 

I certify that my answers are true and complete to the best of my knowledge. 

Puneet Kumar
2021/04/20
Signature: Date: 
(YYYY/MM/DD)