Public Health Passenger Locator Form

Thank you for helping us protect your health

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Family Name: FRANKA First Name: NOÉMI Gender: Female

Date of birth: 1997-11-21 Nationality: Romania
Passport or ID card number: Are you a resident of
TZ556612 Belgium?: No
Mobile phone: 0040726778161
email address: noemyfranka@yahoo.com

Arrival date: 2022-03-25

Flight number: W63351 Seat occupied during the flight: 24C

Location From To
North West ( RO RO11 ) 2022-03-10 2022-03-25

Street: Tiensestraat Number: 11C Box: 0301

Country: Belgium Zip/postal code: 3000 City: Leuven

Do you hold any of the following certificates?:

[V] Vaccination certificate

Connecting flight (departing from Brussels): No

I hereby declare that above-mentioned information has been filled in correctly.: [v]

You can modify the PLF up to one day before your arrival in Belgium. Click here to modify your PLF.