Passenger Locator Form: Personal Information

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Passenger Locator Form

You are required to carry your vaccination certificate to be allowed by the border authorities to enter the country.

1. .Personal
. . . . . . . . . . . . . .Information
..................................................
Last Name / Middle / First Name Sex / Age

Sazdov / - / Toni Male / 50

Mobile Phone Number Business Phone Number Home Phone Number


Unique Code
+38975317732 - -
4349547734
Other Phone Number Email Passport
Date Submitted
- [email protected] C1357754
2021-09-09
Professional Driver

1. .Transportation
. . . . . . . . . . . . . . . . . . . . . . .Information
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
Ground transport Plate Number Carrier

Car ST301RG -

Seat Number Date of arrival Point of Entry in the Country

- 2021-09-11 Doirani (North Macedonia)

1. .Permanent
. . . . . . . . . . . . . . . . .Address
..........................................................
Country State / Province City

North Macedonia Probistip Probistip

Street (Name, Number, ZIP) Apartment Number / Previously Visited Country


Cabin Number

Jordan Stojanov 36 2210 -

1. .Temporary
. . . . . . . . . . . . . . . . .Address
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
Country State / Province City

Greece - Nea Potidaea

Street (Name, Number, ZIP) Hotel Name (If Any) / Apartment Number / Cabin
Cruise Ship Name Number
Paralia Neas Potideas 63200 - -
Passenger Locator Form

1. . Secondary
. . . . . . . . . . . . . . . . .Temporary
. . . . . . . . . . . . . . . . .Address
..........................................................
Country State / Province City

Street (Name, Number, ZIP) Hotel Name (If Any) / Cruise Apartment Number /
Ship Name Cabin Number

1. .Emergency
. . . . . . . . . . . . . . . . . .Contact
. . . . . . . . . . . . Information
..............................................................
Last (Family) Name First (Given) Name Country / City

Sazdova Renata North Macedonia /


Probistip
Mobile Phone Number Other Phone Number Email
+38971236925 - [email protected]

1. . .Travel
. . . . . . . . . .Companions
. . . . . . . . . . . . . . . . . . . –. . .Family
...........................................................
Number Last Name / First Name / Passport / ID Age Seat Number

1. . .Travel
. . . . . . . . . .Companions
. . . . . . . . . . . . . . . . . . . –. . .Non-Family
. . . . . . . . . . . . . . . . . ./. .Non-Same
. . . . . . . . . . . . . . . .Household
.......................
Number Last Name / First Name / Passport / ID Group (Tour, Team, Business, Other)

1. . .Digital
. . . . . . . . . .Certificate
.................................................................................
First Name Last Name Passport / ID Number Expiration

Toni Sazdov -/ - -

Type Manufacturer Country Certificate ID


Other Digital / Non Sinopharm North -
Digital Macedonia

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