UK Visas & Immigration

NAME: Radu-Stefan Musat

UNIQUE APPLICATION NUMBER: 1212-0001-1343-5256/00
PASSPORT NUMBER: 058191287
DATE OF SUBMISSION: 12 November 2020 14:57 Greenwich Mean Time
(GMT)
FORM: Public Health Passenger Locator Form
REFERENCE: 5ZAA024776997
REGISTRATION EMAIL: stefan_r_mrs@yahoo.com

Personal information

Email address stefan_r_mrs@yahoo.com

Travel information

Are you exempt from self-isolating for the first 14 Yes

days you are in the UK?

Why are you exempt from self-isolation? i'm a vessel crew member

What are your travel plans? Travel to the UK more than once within 48 hours, for
example as a haulier or crew member

Where will you arrive in the UK? Heathrow Airport

What country are you travelling from? Romania

Which operator will you be travelling with? TURKISH AIRLINES

What is the flight number, train service or ship Airbus A330-300

name that you will arrive on?

What is your seat number? (you must provide your Not specified

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seat number if relevant. Include coach number if
travelling by train, for example coach 5 seat 2)

Will you enter the UK again, within 48 hours of your No

first arrival?

Your planned travel information

When do you plan to arrive in the UK? 13 November 2020 16:05 PM

When do you plan to leave the UK? (optional) 13 November 2020

Personal information

Are you completing this form for someone else? No

Given name(s) Radu-Stefan

Family name Musat

What is your sex? Male

Residential address Str. Mihail Eminescu, Nr. 87

Techirghiol
Constanta
906100
Romania

Are you able to be contacted by telephone? I can be contacted by telephone call and text
message (SMS)

Date of birth 27 May 2020

Provide your primary telephone number +40 749780661

Passport details

Passport number or travel document reference 058191287

number

Issuing authority Romania

Issue date 9 October 2020

Expiry date 9 October 2029

Emergency contact

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Their name Cory Brothers Shipping Agency Limited

Their telephone number +447831604901

Their email address agency.thames@corybrothers.com

Declaration
I declare that:

I will arrive in the UK within the next 48 hours

the information I have entered in this form is correct
I have given permission to receive a copy of my form via email

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

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