Cargo Claim Form
The Insurers do not admit liability by the issue of this form.
Claimant ___________________________________________________ Phone _______________________________
Address ____________________________________________________ Fax _________________________________
___________________________________________________________
Cargo Details
Policy/Certificate number ________________________________________________________________________________
Description of cargo _____________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
Number & type of packages _______________________________________________________________________________
Cargo containerid? yes∼no If yes, FCL LCL ISO hard top ISO open top ISO flat rack
ISO insulated box Other
Container number ________________________________
Voyage Details
白头老干心不老打一字From __________________________ Transhipped ___________________________ To ____________________
Vesl name(s) __________________________________ Voyage/Flight no(s) ___________________________________
生产实习报告格式 Import Export Within China
Terms of sale Ex works CFR FOB CIF FIS Other
Date goods · Unloaded from overas vesl/craft / / · Received at final store / /
Shipping Company / Airline name _________________________________________________________________________
Road Carrier’s name _________________________________________________________________________
Customs Agent’s name __________________________________________________________________________
Address __________________________________________________________________________
Loss Details
Plea describe the nature of the damage and how it occurred
______________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Date damage discovered / / Customs inspection date / / at ____________________________
Loss estimate $ ______________________
Cau of loss/damage attributed to: ____________________________________________________________深度工作_____________
______________________________________________________________________________________________________
Action taken to reduce damage/safeguard cargo _______________________________________________________________
______________________________________________________________________________________________________
台湾行
Was the damage/loss noted at the time of delivery? yes ∼no (Plea circle)
企业运营管理
黑八台球规则If no, why not? _________________________________________________________________________________________
If yes, was this noted on delivery documentation? yes∼no
Describe the external condition of the packages when delivered __________________________________________________
______________________________________________________________________________________________________
Has the shipping company/carrier surveyed the damage? 创业想法分析书 yes∼no
Has a claim been lodged against the shipping company/carrier? yes∼no
Documentation
· Original documents are required.
· Plea tick the name of each document attached to this form.
❑Commercial invoice
❑Packing list中介语
❑Original marine insurance policy/certificate of insurance
❑Original bill of lading/airway bill (or legible copy with rever side)
❑Claud delivery receipt;
❑Letter against common carrier and their reply (if any)
❑Photos
❑Claim notes/Statement of Claim
❑Other relevant documents
Anti-fraud Notice (Required by JS CIRC)
Good faith reprents a fundamental principle underlying an insurance contract and any person suspected of insurance fraud will be subject to the following liabilities
Criminal Liability: Criminal activities of insurance fraud may be subject to punishment of criminal detention, imprisonment, fines or penalties, or confiscation of property. The apprair and/or certifier of an insured event who intentionally provides fal supporting documents for any other person to commit an insurance fraud will be punished as an accomplice for crime of insurance fraud.
