Passenger Locator Form

STATUS: NON-RED LIST

VACCINE STATUS: DECLARED FULL/EXEMPT

The code contains personal

information. By sharing the code,
you will be sharing your passenger
locator form data.

Summary
Name Catalin Hoka
Passport number 058152530
Which company are you travelling with? Wizz Air
What is the flight number, train number or ship W6 3303
name that you will arrive on?
Reference UKVI_5ZAA027958627
Status NON-RED LIST
What are your travel plans? Stay in the UK
Are you required to self-isolate when you arrive in I need to self-isolate when I arrive in the UK
the UK?
Are you required to book a COVID-19 test Yes
package for when you arrive in the UK?
Your test package booking reference NWPCV4932437
Arrival location London Luton Airport (LTN)
Date of arrival 18 December 2021 13:50 Greenwich Mean Time
(GMT)
Date of submission 17 December 2021 12:22 Greenwich Mean Time
(GMT)

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 UK Visas & Immigration

Personal information

Email address hokacatalin@yahoo.com

Travel information

Do you have an address for where you will stay Yes

during your first 10 days in the UK?

You provided the following address as your Yes

residential address. Do you plan on staying at this
address?
235A DOWNS BARN BOULEVARD
DOWNS BARN
MILTON KEYNES
MK14 7QA

What address will you stay at for your first 10 days 235A DOWNS BARN BOULEVARD
in the UK? DOWNS BARN
MILTON KEYNES
MK14 7QA

When will you arrive there? 18 December 2021

Are you required to self-isolate when you arrive in I need to self-isolate when I arrive in the UK
the UK?

What are your travel plans? Stay in the UK

Where will you arrive in the UK? London Luton Airport (LTN)

What country or territory are you travelling from? Romania

Which company are you travelling with? Wizz Air

What is the flight number, train number or ship W6 3303

name that you will arrive on?

Your cabin type or your coach number Aircraft - Economy

Which countries or territories have you been in, or Romania

will you be in, for the 10 days before coming to the
UK?

Did you transit through this country or territory via No

plane or train without passing Border Control?

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 UK Visas & Immigration
Have you visited, or will you visit, any islands in this No
country or territory during the 10 days before you
arrive in the UK?

Arrival date (optional) 12 December 2021

Departure date 18 December 2021

Are you required to book a COVID-19 test package Yes

for when you arrive in the UK?

Your test package booking reference NWPCV4932437

Your dates of travel

When do you plan to arrive in the UK? 18 December 2021 13:50 PM

Personal information

Given name(s) Catalin

Family name / Surname Hoka

What is your sex? Male

Is your home address in the UK? Yes

Home address 235A DOWNS BARN BOULEVARD

DOWNS BARN
MILTON KEYNES
MK14 7QA
(address verified)

How can we contact you when you are in the UK? I can be contacted by phone call and text message
(SMS)

Date of birth 20 December 1984

Your primary phone number +44 7482529502

Do you meet the COVID-19 vaccination eligibility Yes

criteria for reduced isolation and testing
requirements?

Do you have a QR code that you can use to verify No

your vaccination status?

Have you provided proof of your vaccination No

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 UK Visas & Immigration
status?

How do you meet the COVID-19 vaccination status I am fully vaccinated by a recognised programme
eligibility requirements?

Which country or territory did you receive your England (United Kingdom of Great Britain and
COVID-19 vaccination(s) in? Northern Ireland)

Passport and travel document details

Passport number or travel document reference 058152530

number

Country of Issue Romania (ROU)

Expiry date 27 September 2029

People you are travelling with

Are you travelling to the UK with anyone under 18 Yes

years old that you are including on this form?

Given name(s) Philip Nicholas

Family name / Surname Hoka

Relationship to you Son

Date of birth 24 November 2018

Is the person you are including 12 to 17 years old? No

Declaration
I declare that:

I understand I have to provide proof of my negative PCR or LFD coronavirus (COVID-19) test result, unless
I am exempt
I understand that I must bring proof of my COVID-19 vaccination status if I meet the eligibility criteria. My
proof of vaccination status (if declared) contains my full name, date of birth, vaccine brand and
manufacturer, the dates for all my vaccination doses and the country of vaccination and/or certificate
issuer
The information I have entered in this form is correct
I understand it could be a criminal offence to provide false details and I may be prosecuted

I confirm that I understand and agree with the above declarations.

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