Caribbean Airlines - Plan & Book - Baggage Information - Damaged,Delayed & lost

Baggage Claim Form

* Fields are mandatory

* Claimant’s Title

*Claimant’s First Name:

Claimant’s Middle Name:

*Claimant’s Last Name:

*Permanent Mailing Address 1:

Permanent Mailing Address 2:

*City/Town:

*State/Province:

*Zip Code/Post Code:

*Country:

*Mobile:

[Note: No dashes or spaces]

Telephone Number:

*Email Address:

*Statement of Claim:

is hereby in the amount of $ for baggage and personal effects.

Lost

Yes

Damaged

Yes

TRAVEL ITINERARY

FROM	TO	AIRLINE	FLIGHT NO.	CLASS	DATE

Passenger Ticket Number

Issued in Name of

Was lost or damaged baggage checked?

Yes

Was property issued under your own policy?

Yes

Total number of pieces of checked luggage

Number of pieces lost

Number of pieces damaged

Total weight of checked baggage (if known)

in kilos

in pounds

Was baggage pooled?

Yes

If so, how many passengers?

Baggage tag/check number(s) of lost piece(s)

If yes, list excess baggage ticket number(s)

Did you declare excess valuation?

Yes

If yes how much?

Condition of property when received by Claimant (Complete for damaged/pilferage only)

NOTICE OF LOSS OR BAGGAGE

(a) Claimant last saw property sound and complete at
on

(b) Claimant took custody of property from

(d) Claimant gave first notice of loss or damage in writing to

Airline at

GIVE ANY OTHER INFORMATION WHICH YOU MAY POSSESS IN REFERENCE TO THIS CLAIM

*LIST LOST OR DAMAGE

ARTICLE
(LIST CONTENTS OF EACH PIECE OF BAGGAGE SEPARATELY)

WHEN
PURCHASED

WHERE
PURCHASED

PRICE PAID

COST TO REPAIR

AMOUNT
CLAIMED

Add another item

Supporting Documents? - (Property Irregularity Report, Excess Baggage Receipt. Additional List)

[Note : Max file size 3MB.
.doc / .docx / .pdf / .jpg / .gif format documents only]

It is expressly understood and agreed by me that the furnishing of this form and any assistance furnished by the employees of any Carrier are acts of courtesy and are not an admission of liability by or on the part of any Carrier. Any other information and/or documents relating to this claim which are required by any Carrier will be furnished by me upon request and shall be considered a part of this claim.

The statements contained herein, including the values placed upon the articles enumerated above are true and correct to the best of my knowledge and belief.