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 Gregory Myron Walker
Passport number A06514423
Which company are you travelling with? Qatar
What is the flight number, train number or ship QR0015
name that you will arrive on?
Reference UKVI_5ZAA032267140
Status NON-RED LIST
Are you required to book a COVID-19 test Yes
package for when you arrive in the UK?
Your test package booking reference OOONE1420427
Arrival location London Heathrow Airport (LHR)
Date of arrival 30 January 2022 20:00 Greenwich Mean Time
(GMT)
Date of submission 29 January 2022 13:59 Greenwich Mean Time
(GMT)

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 UK Visas & Immigration

Personal information

Email address gwalker82563@gmail.com

Your Profile

Given name(s) Gregory Myron

Family name / Surname Walker

What is your sex? Male

Date of birth 7 November 2001

Your primary phone number +44 7485123662

Your secondary phone number (optional) +27 767397262

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 BRUNSWICK HOUSE

87 NEWMARKET ROAD
CAMBRIDGE
CB5 8FS
(address verified)

Passport number or travel document reference A06514423

number

Country or territory of issue South Africa (ZAF)

Expiry date 25 January 2028

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?

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 UK Visas & Immigration
BRUNSWICK HOUSE
87 NEWMARKET ROAD
CAMBRIDGE
CB5 8FS

What address will you stay at for your first 10 days BRUNSWICK HOUSE
in the UK? 87 NEWMARKET ROAD
CAMBRIDGE
CB5 8FS

When will you arrive there? 30 January 2022

When will you leave there? 10 February 2022

Where will you arrive in the UK? London Heathrow Airport (LHR)

What country or territory are you travelling from? Qatar

Which company are you travelling with? Qatar

What is the flight number, train number or ship QR0015

name that you will arrive on?

Your cabin type or your coach number Aircraft - Business

Which countries or territories have you been in, or Qatar

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 30 January 2022

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

for when you arrive in the UK?

Your test package booking reference OOONE1420427

Your dates of travel

When do you plan to arrive in the UK? 30 January 2022 20:00 PM

Personal information

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 UK Visas & Immigration

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

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)

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 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
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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