Baggage Claim

 
Personal Information
Given name(s) Last name(s)
Full Name:*
Contact telephone:
Address of residence:*
Temporary address:
E-mail address:*
Alternate e-mail address:
Frequent flyer status:
Frequent flyer #:
Flight information:
 
Reservation code :
Date of flight:*
Flight #:
City of origin:*
City of destination:*
Did you travel with another airline?*
Airline:*
City of origin:*
City of destination:*
Claim Details
  • Part #*

    Baggage tag #:

  • Add a piece of baggage
Name of the passenger involved:*
Type of baggage involved:*

Type of claim:*


Total value claimed (USD):*
Did you take out insurance on this piece of baggage?*
Insurer:
Brand of baggage:*
Surface of the baggage:*
Color of the baggage:*
Year baggage was purchased:
 
List of missing items
Item*
Place of purchase*
Date of purchase*
Original cost*
Cost claimed*
 
Name of the passenger involved:*
Type of baggage involved:*

Type of claim:*


Total value claimed (USD):*
Did you take out insurance on this piece of baggage?*
Insurer:
Brand of baggage:*
Surface of the baggage:*
Color of the baggage:*
Year baggage was purchased:
 
List of missing items
Item*
Place of purchase*
Date of purchase*
Original cost*
Cost claimed*
 
Name of the passenger involved:*
Type of baggage involved:*

Type of claim:*


Total value claimed (USD):*
Did you take out insurance on this piece of baggage?*
Insurer:
Brand of baggage:*
Surface of the baggage:*
Color of the baggage:*
Year baggage was purchased:
 
List of missing items
Item*
Place of purchase*
Date of purchase*
Original cost*
Cost claimed*
 
Name of the passenger involved:*
Type of baggage involved:*

Type of claim:*


Total value claimed (USD):*
Did you take out insurance on this piece of baggage?*
Insurer:
Brand of baggage:*
Surface of the baggage:*
Color of the baggage:*
Year baggage was purchased:
 
List of missing items
Item*
Place of purchase*
Date of purchase*
Original cost*
Cost claimed*
 
Name of the passenger involved:*
Type of baggage involved:*

Type of claim:*


Total value claimed (USD):*
Did you take out insurance on this piece of baggage?*
Insurer:
Brand of baggage:*
Surface of the baggage:*
Color of the baggage:*
Year baggage was purchased:
 
List of missing items
Item*
Place of purchase*
Date of purchase*
Original cost*
Cost claimed*
 
Name of the passenger involved:*
Type of baggage involved:*

Type of claim:*


Total value claimed (USD):*
Did you take out insurance on this piece of baggage?*
Insurer:
Brand of baggage:*
Surface of the baggage:*
Color of the baggage:*
Year baggage was purchased:
 
List of missing items
Item*
Place of purchase*
Date of purchase*
Original cost*
Cost claimed*
 
Name of the passenger involved:*
Type of baggage involved:*

Type of claim:*


Total value claimed (USD):*
Did you take out insurance on this piece of baggage?*
Insurer:
Brand of baggage:*
Surface of the baggage:*
Color of the baggage:*
Year baggage was purchased:
 
List of missing items
Item*
Place of purchase*
Date of purchase*
Original cost*
Cost claimed*
 
Name of the passenger involved:*
Type of baggage involved:*

Type of claim:*


Total value claimed (USD):*
Did you take out insurance on this piece of baggage?*
Insurer:
Brand of baggage:*
Surface of the baggage:*
Color of the baggage:*
Year baggage was purchased:
 
List of missing items
Item*
Place of purchase*
Date of purchase*
Original cost*
Cost claimed*
 
Name of the passenger involved:*
Type of baggage involved:*

Type of claim:*


Total value claimed (USD):*
Did you take out insurance on this piece of baggage?*
Insurer:
Brand of baggage:*
Surface of the baggage:*
Color of the baggage:*
Year baggage was purchased:
 
List of missing items
Item*
Place of purchase*
Date of purchase*
Original cost*
Cost claimed*
 
Name of the passenger involved:*
Type of baggage involved:*

Type of claim:*


Total value claimed (USD):*
Did you take out insurance on this piece of baggage?*
Insurer:
Brand of baggage:*
Surface of the baggage:*
Color of the baggage:*
Year baggage was purchased:
 
List of missing items
Item*
Place of purchase*
Date of purchase*
Original cost*
Cost claimed*
 
 
Expenses incurred while waiting for your baggage
.
Item*
Place of purchase*
Date of purchase*
Cost (USD)*
 
 
Enclose receipts for essential expenses
.
 
Additional comments:

.

Comments:
 
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