Passenger Locator Form

STATUS: NON-RED LIST

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 Monteha Karim Hamad Hamad
Passport number 36471206
Which company are you travelling with? Ryanair
What is the flight number, train number or ship R5VK8Y
name that you will arrive on?
Reference UKVI_5ZAA033410843
Status NON-RED LIST
Are you required to self-isolate when you arrive in I need to self-isolate when I arrive in the UK or I
the UK? arrive after 11 February 2022 04:00
Are you required to book a COVID-19 test Yes
package for when you arrive in the UK?
Your test package booking reference Rtngo1137329
Arrival location London Stansted Airport (STN)
Date of arrival 11 February 2022 11:55 Greenwich Mean Time
(GMT)
Date of submission 09 February 2022 19:50 Greenwich Mean Time
(GMT)

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Personal information

Email address zeineb-1999@hotmail.com

Travel information

Do you have an address for where you will stay Yes

during your first 10 days in the UK?

Who are you planning to stay with in the UK? Zayneb Al-graifee

What address will you stay at for your first 10 days 26 FAIR CLOSE
in the UK? BUSHEY
WD23 1FR

When will you arrive there? 11 February 2022

When will you leave there? 22 February 2022

Are you required to self-isolate when you arrive in I need to self-isolate when I arrive in the UK or I
the UK? arrive after 11 February 2022 04:00

Where will you arrive in the UK? London Stansted Airport (STN)

What country or territory are you travelling from? Sweden

Which company are you travelling with? Ryanair

What is the flight number, train number or ship R5VK8Y

name that you will arrive on?

Your cabin type or your coach number Aircraft - Economy

Which countries or territories have you been in, or Sweden

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?

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?

Departure date 11 February 2022

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

for when you arrive in the UK?

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Your test package booking reference Rtngo1137329

Are you using Test to Release? No

Your dates of travel

Which date do you plan to arrive in the UK? 11 February 2022 11:55 AM

When do you plan to leave the UK? (optional) 22 February 2022

Personal information

Given name(s) Monteha

Family name / Surname Karim Hamad Hamad

What is your sex? Female

Is your home address in the UK? No

Home address Ålgatan 3 lgh 1102

Stockholm
Sweden

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 8 December 1977

Your primary phone number +46 763494987

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

criteria for reduced isolation and testing
requirements?

Passport and travel document details

Passport number or travel document reference 36471206

number

Country or territory of issue Sweden (SWE)

Expiry date 8 October 2026

People you are travelling with

Are you travelling to the UK with anyone under 18 Yes

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years old that you are including on this form?

Given name(s) Laila

Family name / Surname Al-graifee

Relationship to you My Child

Date of birth 30 March 2005

Is the person you are including 12 to 17 years old? Yes

Passport number or travel document reference 96528826

number of the minor

Country of Issue Sweden (SWE)

Expiry date 10 June 2024

Given name(s) Fatima

Family name / Surname Al-graifee

Relationship to you My child

Date of birth 26 November 2016

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

Given name(s) Melika

Family name / Surname Al-graifee

Relationship to you My child

Date of birth 20 August 2021

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 or meet vaccine eligibility criteria
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

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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.

Monteha Karim Hamad Hamad Page 5 of 5