Public Health Passenger Locator Form

Thank you for helping us protect your health

b44cdc85-7daa-4416-9d9e-6f375639bcda

Family Name: MIŠI? First Name: BRANKO Gender: Male

Date of birth: 1968-02-02 Nationality: Serbia
Passport or ID card number: Are you a resident of
050056008 Belgium?: No
Mobile phone: +381638413242
email address: branko.misic@mod.gov.rs

Arrival date: 2022-05-09

Flight number: LO233

Category: Other

Location From To
Bosnia and Herzegovina ( BA ) 2022-04-26 2022-04-29

Street: Hotel Warwick Brussels, Rue Duquesnoy Number: 5

Country: Belgium Zip/postal code: 1000 City: Brussels

Do you hold any of the following certificates?:

[V] Negative test 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.