Passenger-locator-form.com

The Passenger Locator Form, is an online form, which must be completed before your travel. This online formular helps in the contact tracing. The Passenger Locator Form does not replace an Evisa and must be completed separately from the Evisa.

Application for EU dPLF
Italy Passenger Locator Form

Notice: The PLF Italy is a Mandatory form to enter Italian territory regardless your nationality (European citizens are also subject to this obligation) and regardless your mode of transport: by plane, by boat or by land (car, bus, train) including.

Country of residence* *

You are traveling by *

Aircraft Flight Information

Please fill in the details of your flight

Boarding Country / Place *

Date/time of Departure

Day *

Month *

Year *

Departure Time *

NOTE : Your Travel date must be greater than equal to today

Arrival date*

Day *

Month *

Year *

Arrival Time *

Final Destination (Airport) *

Preciser le moyen de transport *

Voiture / Autre Véhicule Numéro de plaque *

Departure country *

Date / heure d'embarquement *

Point d'entrée dans le pays *

Date / heure d'entrée dans le pays *

Numéro de siège

Numéro du bus

Type de siège

Point d'entrée dans le pays *

Date / heure d'arrivée *

Transport ferroviaire *

Train Nombre

Numéro de wagon

Pays d'embarquement *

Gare d'embarquement *

Date / heure d'embarquement *

Personal Information

Last (family) name *

First (given) name *

ID Document Type (optional)

ID Card Passport

Phone number(s) where you can be reached if needed.

Primary Telephone Number *

Enter a plus sign (+) followed by your country code and your phone number, e.g. +306989123456.

Other Telephone Number

Enter a plus sign (+) followed by your country code and your phone number, e.g. +306989123456.

Email Address *

Enter your username/mailbox name followed by the @ symbol and the domain name, e.g. jsmith@example.com.

Gender *

Male Female

Please fill in the address of your permanent residence

Previously Visited Countries*

If in the 14 days prior to your arrival you have stayed in a country (not transit) other than your permanent address, declare below the countries/cities where you stayed

If, in the next 14 days, you will not be staying at the permanent address you declared in the previous step, fill the places where you will be staying. (If you are a visitor, write only the first place where you will be staying)

Street (street number, street, type: street, ave, bd, ..) *

Name of the hotel / Name of the guest house *

Travel Companions – Family

Declaration

Declaration according the art. 50 of DPCM 02/03/21 to enter Italy

I have been / transit in the following countries and territories in the last 14 days: *

I will enter in the following Italian Region *

Travelling from a Country of the List?

List C (EU/EEA/Israel/Canada)
UK
List D ( USA /Canada and Japan)
List E

Please select one of the choices below

I’m in one of the exemptions provided by the art. 51 of the DPCM of 02/03/21
I will present a valid certificate of:

completion of the full vaccination cycle with an EMA-approved vaccine at least from 14 days ago
recovery from COVID-19, with concomitant cessation of prescribed isolation following SARS-CoV-2 infection
a performed a rapid antigenic or molecular test with a negative result for SARS-CoV-2 within 48 hours prior to entry into the country

Je présenterai un certificat valide d'un test rapide d'antigène ou moléculaire préformé avec un résultat négatif pour Infection au SRAS-CoV-2 ET je vais subir 5 jours d'auto-isolement et prendre un autre test d'écouvillonnage d'antigène à la fin de l'auto-isolement
Je viens du Canada, du Japon et des États-Unis et je présenterai un certificat valide de Un antigène rapide préformé ou un test moléculaire avec un résultat négatif pour l'infection par le SRAS-CoV-2. Achèvement du cycle complet de vaccination avec un vaccin approuvé par l'EMA ou rétablissement du COVID-19 avec cessation concomitante de l'isolement prescrit à la suite d'une infection par le SRAS-CoV-2

Please select one of the choices below

I’m in one of the exemptions provided by the art. 51 of the DPCM of 02/03/21
I will present a valid certificate of:

completion of the full vaccination cycle with an EMA-approved vaccine at least from 14 days ago
recovery from COVID-19, with concomitant cessation of prescribed isolation following SARS-CoV-2 infection
a performed a rapid antigenic or molecular test with a negative result for SARS-CoV-2 within 48 hours prior to entry into the country

Please select one or more of the choices below

I will present the certification attesting the negative result of a molecular test (RT PCR) or antigenic test, carried out by means of a swab, no later than 48 hours before entering in Italy (children up to 6 years are exempted from the test)
I will undergo to 5 days of quarantine with a test and I will notify my arrival in Italy to the Local Health Authority
I’m in one of the exemptions provided by the art. 51 of the DPCM of 02/03/21

Quarantine information (for any details click here)

Are you in any of the exemptions provided by the art. 51 of the DPCM of 02/03/21? If yes please indicate which one

Yes
No

Do you have an Exemption issued by the Italian Ministry of Health?

Yes
No

I will notify my arrival in Italy to the Local Health Authority

Full address of the place or residence in Italy where the period of health surveillance and quarantine will be carried out fiduciary isolation

The private means of transport that will be used to reach the place of quarantine 1) or, exclusively in the case of entry into Italy by scheduled air transport, additional scheduled air transport which is expected to be used to reach the place of final destination and the identification code of the identification code of the travel document

Passenger-locator-form.com

Application for EU dPLF Italy Passenger Locator Form

Application for EU dPLF
Italy Passenger Locator Form