Inventory List - Lost Baggage Questionaire

* Has the loss been reported Yes   No
* File reference
* Family / Last Name
* First Name
* Permanent Address
* Town / City / State
* Postal / Zip Code
* Country
* Phone
* Email
  Tag Number/s
* Flight Number / Date
* Journey from / to
* Description of baggage
  Brand name of bag (i.e.Samsonite, Adidas, if known)
* Is your baggage insured Yes   No
  Insurance Company
  Please advice if baggage is possible named with another name and address then yours. i.e. Address and Name on bag
* We kindly ask you to enter value and full description of damaged or missing items from luggage
  Bank Name
  S.W.I.F.T number
  IBAN number:
  Account Number
* Total claim amount
* I hereby certify that above information is true and complete