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

RUSANU / VALENTIN / CLAUDIU Male / 52

Mobile Phone Number Business Phone Number Home Phone Number

Unique Code
+40768956104 - -
4302498536
Other Phone Number Email National ID
Date Submitted
+40766546875 teodora.rusanu@gmail.com 1681215345398
2021-08-21
Professional Driver

1. .Transportation
. . . . . . . . . . . . . . . . . . . . . . .Information
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
Ground transport Plate Number Carrier

Car TR 97 RTL -

Seat Number Date of arrival Point of Entry in the Country

- 2021-08-23 Nymphaea (Bulgaria)

1. .Permanent
. . . . . . . . . . . . . . . . .Address
..........................................................
Country State / Province City

Romania Teleorman ALEXANDRIA

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

Cabin Number

CUZA VODA 74 140036 10

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

Greece - KOINIRA

Street (Name, Number, ZIP) Hotel Name (If Any) / Apartment Number / Cabin
Cruise Ship Name Number
KOINIRA 140036 KAPSOGEORGIS ROOMS 12
 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

STOICA CATALIN Romania / BUCURESTI

Mobile Phone Number Other Phone Number Email

+40744685235 - monica.rusanu@yahoo.co
m

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

1 RUSANU / MONICA / 2680325345381 53 -

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

CLAUDIU RUSANU -/ - -

Type Manufacturer Country Certificate ID

Other Digital / Non Pfizer BioNtech Romania -
Digital