Passenger Locator Form

STATUS: GREEN
VACCINE STATUS: NO/NOT DECLARED

The code contains personal

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

Summary
Name Loredana-Lacramioara Cavalciuc
Passport number 054594834
Which company are you travelling with? WIZZ AIR HUNGARY LTD
What is the flight number, train number or ship VH1DJR
name that you will arrive on?
Reference UKVI_5ZAA014777714
Status GRN
What are your travel plans? Stay in 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 DANTF0359400
Arrival location London Luton Airport (LTN)
Date of arrival 17 September 2021 23:40 British Summer Time
(BST)
Date of submission 17 September 2021 10:31 British Summer Time
(BST)

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 UK Visas & Immigration

Personal information

Email address loredanalacramioara2@gmail.com

Your Profile

Given name(s) Loredana-Lacramioara

Family name / Surname Cavalciuc

What is your sex? Female

Date of birth 30 October 2002

Your primary phone number +44 7443212364

Your secondary phone number (optional) +44 7425654959

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

Is your home address in the UK? Yes

Home address 222B

Ballam street
E13 8RA
London
E13 8RA
(manually entered)

Passport number or travel document reference 054594834

number

Country of Issue Romania (ROU)

Expiry date 11 April 2022

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?
222B
Ballam street

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 UK Visas & Immigration
E13 8RA
London
E13 8RA

What address will you stay at for your first 10 days 222B
in the UK? Ballam street
E13 8RA
London
E13 8RA

When will you arrive there? 17 September 2021

When will you leave there? 18 September 2021

What are your travel plans? Stay in the UK

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

What country are you travelling from? Romania

Which company are you travelling with? WIZZ AIR HUNGARY LTD

What is the flight number, train number or ship VH1DJR

name that you will arrive on?

What is your seat number? 24F

Which countries have you been in, or will you be in, Romania
for the 10 days before coming to the UK?

Have you visited, or will you visit, any islands in this No

country during the 10 days before you arrive in the
UK?

Arrival date 18 September 2021

Departure date 18 September 2021

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

for when you arrive in the UK?

Your test package booking reference DANTF0359400

Your dates of travel

When do you plan to arrive in the UK? 17 September 2021 23:40 PM

When do you plan to leave the UK? (optional) 20 June 2025

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 UK Visas & Immigration
Personal information

Do you meet the COVID-19 vaccination eligibility No/Prefer not to say

criteria for reduced isolation and testing
requirements?

People you are travelling with

Are you travelling to the UK with anyone under 18 No

years old that you are including on this form?

Declaration
I declare that:

I will arrive in the UK within the next 48 hours

I understand I have to provide proof of a negative COVID-19 test prior to departure to the UK (unless I am
exempt)
I understand that I must bring proof of my COVID-19 vaccination status if I meet the eligibility criteria
I have provided my seat number, if relevant
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

If any of your information changes once you have submitted your form, such as travel details, seat number, or
contact information, you must complete a new form.

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

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