Delayed Baggage Documents.Pdf
Total Page：16
File Type：pdf, Size：1020Kb
Property Questionnaire Claim No. Travel Date Frequent Flyer No. SUCCESSFUL TRACING AND RESOLUTION OF A CLAIM DEPENDS UPON PROMPT COMPLETION AND RETURN OF THIS FORM. FAILURE TO RETURN THIS FORM WITHIN 30 DAYS FROM THE DATE OF LOSS WILL PREVENT CONSIDERATION OF THE CLAIM. It is important that you retain a copy of all documents for your records. REQUIRED DOCUMENTS: Passenger ticket receipt, baggage claim check, receipt for excess value claimed or excess baggage charges paid, receipt or proof of ownership for items valued over $ 100. Title First Middle Last Name Telephone Numbers: Home: Fax: Permanent Mailing Number Street Apt. Temporary Mailing Number Street Apt. Address Address City State Zip Code City State Zip Code Country Postal Code Country Postal Code Employed by: Occupation e-mail Mobile Telephone No. Your Complete Flight ltinerary From To Airline Flight Number Travel Date Have you, or any member of your household, had a previous baggage claim with AA or any other airline? ⅪYes Ⅺ No If Yes Airline(s) Date(s) No. of ticketed passengers traveling? Number of passengers claiming missing Purpose of trip? Length of stay? baggage? Were you charged for excess baggage? Yes Ⅺ No Ⅺ Did you declare and pay for excess value? Yes Ⅺ No Ⅺ Value declared $ Have you received your baggage and are you missing contents only? Yes Ⅺ No Ⅺ If yes, how many bags are missing contents? Was airline notified of loss immediately? Yes Ⅺ No Ⅺ If yes, at what office? By telephone Ⅺ In person Ⅺ If airline was not notified within 4 hours, state the reason for delay. Has this loss been reported to another airline? Yes Ⅺ No Ⅺ If yes, please provide name of airline and city where reported. Certification and Understanding FOR USE IN USA ONLY. It is expressly understood and agreed by the claimant that the furnishing of this form and any assistance given by employees of American Airlines, Inc., are acts of courtesy and shall not constitute a wavier of any rights or an admission of liability by or on the part of American Airlines, Inc. its employees or agents. Any other information and/or documents relating to this statement which are required by American Airlines, Inc., will be furnished by claimant upon request and shall be considered part of this statement. The United States Post Office has investigative jurisdiction under federal laws relating to sending false or fraudulent claims through the United States mail and any such claims received by American Airlines, Inc., are reported to the United States Postal Authorities. Loss of baggage in interstate shipment or of articles from such baggage come within the purview of federal statutes relating to thefts from interstate shipment and, are therefore, subject to investigation by the Federal Bureau of Investigation. Reply to: American Airlines, Inc. Central Baggage Service Toll Free: 1-800-866-4010 P.O. Box 619613 - MD 1322 Local: 972-425-5240 aa.com/bagstatus Dallas/Ft. Worth, TX 75261-9613 Facsimile: 972-425-0714 Complete Reverse Side BAGGAGE AND CONTENT DESCRIPTION NOTE: When more than one piece of baggage is lost, complete a separate baggage and content list for each missing bag. Baggage routing: Flight number(s) on claim check: Checked from: Checked to: Baggage tag number(s): Passenger ticket number(s): Number of bags checked: Number of bags received: Baggage checked at: Curbside Ticket Counter Gate Other Was baggage rechecked and new tags issued? Yes No If yes, at what airport? Was baggage available at Customs? Yes No N/A Give details if the original routing was changed after starting your trip: Was your property packed in a box? Yes No Was your property packed with an external cover? (example golf bag) Yes No Is the name on the bag(s) different from passenger? If so, what name? Please list any initials, marks, tags, ribbons, cords, tape or other exterior markings on your bag(s): Type Bag Material Color Brand Bag Open/Close Wheels Combo Pockets Straps Retractable Purchase Cost of (see chart) Dimensions with Zipper Lock Handle Date Bag Yes Yes Yes Yes Yes Yes No No No No No No Gender = M: Male, F: Female, CH: Child, I: Infant (under 2 yrs.) Qty Article/ Size Gender Store Purchase Original Description Color Material Brand Label Item M,F, CH, I Purchased Date Cost 1 Shoes 12 M White with blue stripes Leather Nike Sears Jan-00 $55.00 If additional space is needed, please attach a separate page. Be sure to include a complete description and cost for each item along with receipts for all items over $100.00. Total $ I do hereby warrant the foregoing statement and those on the accompanying forms to be accurate, complete and true. I hereby make a claim against American Airlines, Inc., in the amount of $ for a loss occurring on . Claimant’s Signature If emailing enter email address Date Claimant’s Signature* If emailing enter email address Date *Requires signature for each passenger claiming lost property. Parents may sign for their children under age 18 BAGS THAT CLOSE WITHOUT ZIPPERS 01 HORIZONTAL DESIGN, GENERALLY HARD SHELL 02 UPRIGHT DESIGN, GENERALLY HARD SHELL 03 HORIZONTAL DESIGN, RIGID FRAME, HARD OR SOFT SIDE/MAY HAVE REINFORCED CORNERS 05 HORIZONTAL DESIGN, RIGID FRAME, SOFT SIDED, EXPANDABLE 06 BRIEFCASE 07 FLIGHT/PILOT’S BAG/DOCUMENT CASE 08 MILITARY STYLE BAG 09 PLASTIC/LAUNDRY BAG 10 CARDBOARD/WOODEN BOX 12 STORAGE CONTAINER; MAY HAVE HANDLE/WHEELS BAGS THAT CLOSE WITH ZIPPERS 20 HANGING OR FOLDING GARMENT BAG 22 UPRIGHT DESIGN, SOFT MATERIAL RETRACTABLE HANDLE 22D UPRIGHT DESIGN COMBINED HARD AND SOFT MATERIAL 22R UPRIGHT DESIGN, DURABLE, PLASTIC, MOLDED 23 HORIZONTAL DESIGN SUITCASE THAT SECURES WITH ZIPPER 25 GYM/SPORT TYPE BAG – ALL SIZES, MAY HAVE SHOULDER STRAP AND RETRACTABLE HANDLE 26 SMALL OVERNIGHT OR LAPTOP BAG 27 STANDS UPRIGHT, MAY BE EXPANDABLE, OFTEN HAS WHEELS 28 MATTED WOVEN BAG 29 BACKPACK/RUCKSACK WITH OR WITHOUT FRAME, MAY HAVE RETRACTABLE HANDLE AND WHEELS MISCELLANEOUS ARTICLES – SPECIAL CONTAINERS 50 HAT BOX 51 COURIER BAG/BOX/PACKAGE 52 TRUNK/SAMPLE/DISPLAY CASE *OFTEN CUSTOM MADE* 53 ART OR DISPLAY PORTFOLIO 54 TUBE WITHOUT SPORTING EQUIPMENT 55 DUTY FREE ARTICLES (NOT LISTED ELSEWHERE) 56 COSMETIC/BEAUTY CASE, ANY STYLE 57 KENNEL/PET CONTAINER SPORTING GOODS 60 FISHING RODS/POLES/STICKS 61 FIREARM(S) 62 GOLF BAG AND/OR CLUBS – SPECIFY COLOR AND BRAND 63 BICYCLE AND/OR ACCESSORIES 64 SLEEPING BAG/BED ROLL/TENT 65 SURF EQUIPMENT – E.G. WIND, KITE, BOOGIE 66 SKIS AND/OR POLES, NORDIC WALKING POLES 67 SNOW BOARDS AND OTHER SLEDDING DEVICES 68 SKI BOOTS AND/OR BOOT BAG 69 SPORTING EQUIPMENT NOT SHOWN ELSEWHERE 75 WHEELED SPORTING ITEMS – E.G., SKATEBOARDS, SCOOTERS 89 CAMPING, FOLDING, COLLAPSIBLE CHAIR BABY/INFANT/CHILD EQUIPMENT 71 CHILD/INFANT CAR SEAT 72 CHILD/INFANT EQUIPMENT NOT LISTED ELSEWHERE – E.G., INFANT CARRIER, PLAYPEN 73 FULL SIZE PRAM/BABY CARRIAGE/JOGGER 74 UMBRELLA STROLLER PHOTOGRAPHIC/ELECTRONIC/MUSICAL/COMMUNICATION EQUIPMENT 81 AUDIO/VIDEO/VISUAL/PHOTO EQUIPMENT – E.G., TELEVISION, DVD, VIDEO PLAYERS AND GAMES, RADIO, TAPE/CASSETTE/CD PLAYER 82 COMPUTER/COMMUNICATION EQUIPMENT – E.G. PC COMPUTER, MONITOR, KEYBOARD, LAPTOP, PRINTER, COMPUTER GAMES, TELEPHONE, FAX MACHINE 83 ELECTRICAL APPLIANCES 85 ALL MUSICAL INSTRUMENTS MISCELLANEOUS ARTICLES 90 BAGGAGE TROLLEY 92 SECURITY REMOVED ITEMS 93 SHOPPING BAG – E.G., STRAW, PLASTIC, NYLON 94 WHEELCHAIR – POWERED OR MANUAL AND ACCESSORIES – E.G., SEAT, WHEEL, ETC. 95 ORTHOPEDIC DEVICES OTHER THAN A WHEELCHAIR 96 BEDDING MAY CONTAIN PILLOWS AND BLANKETS 97 DIVE BAG/EQUIPMENT 98 BEACH, PATIO, GOLF, AND RAIN UMBRELLA 99 ARTICLE OTHER THAN BAG NOT APPEARING ON THIS LIST – DESCRIBE ITEM.