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UK Visas & Immigration: Personal Information

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UK Visas & Immigration

NAME: mohit kumar


PASSPORT NUMBER: Z3105032
DATE OF SUBMISSION: 08 February 2021 16:37 Greenwich Mean Time
(GMT)
FORM: Public Health Passenger Locator Form
REFERENCE: UKVI_5ZAA002637757
REGISTRATION EMAIL: mohit.nigania@gmail.com

Personal information

Email address mohit.nigania@gmail.com

Travel information

Do you know where you will stay for your first 10 Yes
days in the UK?

Who are you planning to stay with in the UK? Lisa

What address will you stay at for your first 10 days 120 ASHCROFT ROAD
in the UK? LUTON
LU2 9AX

When will you arrive there? 10 February 2021

When will you leave there? 28 February 2021

Do you need to self-isolate when you arrive in the Yes, I need to self-isolate
UK?

What are your travel plans? Stay in the UK

Which countries have you been in, or will you be in, India
for the 10 days before coming to the UK?

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UK Visas & Immigration

Enter any islands you have, or will, visit within this none
country.

Departure date 10 February 2021

Have you opted-in to Test to Release? No

Where will you arrive in the UK? Heathrow Airport

What country are you travelling from? India

Which operator will you be travelling with? Virgin Atlantic

What is the flight number, train service or ship VS0301


name that you will arrive on?

What is your seat number? (you must provide your 66A


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

Your planned travel information

When do you plan to arrive in the UK? 10 February 2021 17:20 PM

Personal information

Given name(s) mohit

Family name kumar

What is your sex? Male

Is your home address in the UK? No

Home address alwar rajasthan


alwar
rajasthan
301702
India

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

Date of birth 28 February 1993

Provide your primary telephone number +91 9041083108

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UK Visas & Immigration
Passport details

Passport number or travel document reference Z3105032


number

Issuing authority Jaipur

Issue date 17 December 2014

Expiry date 28 December 2024

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 will arrive in the UK within the next 48 hours


I understand I have to provide proof of a negative COVID 19 test prior to departure to the UK (unless
exempt)
I have provided my seat number, if relevant
The information I have entered in this form is correct

If any of your information changes once you have submitted your details, such as travel details, seat number, or
contact information, you must complete a new form.

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

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