Passenger Locator Form

You are required to carry a certificate of a negative RT-PCR or antigen (rapid) test result to be allowed by the border authorities to
enter the country. The certificates should be written in English and bear the name and passport/national ID number of the traveler.
You may be retested upon arrival at your point of entry in Greece.

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

Last Name / Middle / First Name Sex / Age

Puller / - / Mirko Male / 24

Mobile Phone Number Business Phone Number Home Phone Number

Unique Code
+393318614653 - -
7143868854
Other Phone Number Email Passport
Date Submitted
- mirkopuller@gmail.com YB0793768
2021-07-31

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

Ryanair FR4988

Date of arrival Point of Entry in the Country

2021-08-02 Corfu

Connection Flight Information

Airline name Flight number Date of arrival

- - -

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

Italy Lombardia Novate Milanese

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

Cabin Number
Raffaello Sanzio 32 20026 -

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

Greece - Corfu

Street (Name, Number, ZIP) Hotel Name (If Any) / Apartment Number / Cabin
Cruise Ship Name Number
Dafnilas, Dassia 49083 Camping village Dionysus -
 Passenger Locator Form

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

Greece - Corfu

Street (Name, Number, ZIP) Hotel Name (If Any) / Cruise Apartment Number /
Ship Name Cabin Number
Xelanes 1, Agios Ioannis 49100 Villa Irini -

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

Puller Riccardo Italy / Novate Milanese

Mobile Phone Number Other Phone Number Email

+393357366799 - riccardo.puller@realemutu
a.it

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 Patroni / Simone / CA05205JH -

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

Mirko Puller -/ - -

Type Manufacturer Country Certificate ID

Other Digital / Non Unknown - -
Digital