CLAIM INFORMATIONAIRBILL OR AIRWAY BILL # AIRFREIGHT CLAIM NUMBER DATE OF SHIPMENT CLAIMANT'S NUMBER CLAIM BREAKDOWN QUANTITY | UNIT | DESCRIPTION | DETAILED REASON FOR CLAIM | AMOUNT OF CLAIMTOTAL AMOUNT OF CLAIM NOTIFICATION OF LOSS OR DAMAGE WAS GIVEN TO By: FAXLETTEROTHERON Click to select a dateAT Click to select a time010203040506070809101112HH000510152025303540455055MMAMPMAM/PMINSPECTION WAS MADE BY: DATE ATTACH ORIGINAL OR CERTIFIED COPY OF THE FOLLOWING SUPPORTING DOCUMENTS (PLEASE NOTE THAT IF YOU HAVE MULTIPLE DOCUMENTS TO SEND FOR ANY OF THE FOLLOWING 7 ITEMS, YOU CAN ONLY UPLOAD ONE FILE FOR EACH OF THE 7 CATEGORIES. IF YOU HAVE MULTIPLE DOCS FOR ANY ONE OF THEM, YOU MUST SCAN THEM AS A SINGLE DOCUMENT.1. COPY OF HOUSEBILL NAME OF CLAIMANT 2. COPY OF DELIVERY RECEIPT OR RECEIPT OF REFUSAL MAILING ADDRESS Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountry3. COPY OF ORIGINAL RECEIPT OF PURCHASE 4. COPY OF RECEIPT OR REPLACEMENT 5. COPY OF YOUR CLIENTS CLAIM AGAINST YOU PHONE 6. PHOTO OF INNER & OUTER PACKAGING & DAMAGE ITEMS (FOR DAMAGE CLAIMS) EMAIL ADDRESS 7. PROOF OF PAYMENT BY YOU TO YOUR CLAIMANT THE FOREGOING STATEMENT OF FACTS IS HEREBY CERTIFIED AS TO CORRECT CLAIMANT OR CLAIMANT'S REPRESENTATIVEDATE Submit Your MessagePlease enter any two digits *Example: 12This box is for spam protection - please leave it blank: