Baggage Claim Form 7##R BR Please complete this form in BLOCK letters and return it to us as soon as possible, Incase of missing baggage, ifthe tracing is unsuccessful, this form will serve as your notice of claim, ALE MU, RUMOUR «MRT PIRATE «UL RATT TAR OTA « Fle reference tat Cx Example i: HKGCX12345, “ype BH Missing beggage SRR OO Damageabeggage ABA® O Others Missing terns) RESO Damagediteris) iE O Rete Name (surname name fist) Meo = O | Ms £2 O 6 ERAT) Ms AAO | Miss isi O somact addvess Contact phone no, Comact addess mitt See we ‘Mobile phone no. Country Moore ohne mailadcress Fax. Emailadcress Rik ae Nationality Ha Passportn SMES] Occupation HR “The Marco Polo Club Menbership No. she RAK Aine #22) Flight no. 0% Day/ Month/Year 18/71 | From {Airport th (8) | __TotAirport) # (RS!) Passenger ticket ro. eon =a “Totalno. of baggage checked-in a sew alos @F7 | Any other cistinctive markings or name! ‘address label alacec on bag CJ LC ‘i etese rece (—] pieces] ates ar) est apsoelan Cc) (__) AIR IRTERRA LO / Juang ctbagaoge issn or araaed kos are | RBFIEN HRT: Tag no. GEMS | * Baggage checked:n at AER (airport) on (date Bi) and checkedto| BiG (Gly shown on baggage chim tag EE HEH ) + Baggage last soon at SFE ILI (airport 8 } on 7 (date BM) + Hove yourechecked ary baggage? RI NIRS RES AIENGTIE? No SO Yes 0) rechecked by Htc (atine EAI) + Hove you paid ary excess baggage charges? MRR AE HIEETTRA? No SO ves tO CSE + Have you paid any excess value declaration charges? MIKE BE /SEAEOUAR LRN? No ZO Yes O + Have you had a previous claim with us or other atines in the past 2 years? AU PAFIBA PRE NN LPT WL AAAS ATM tO 7 No ®O).Yes 0, please provide information Bef ‘Aine REDE Fight No RM | Dayitontnivear /A/A_[ From (Airport th GAR) | To Airport 7 (BS) Name and adaress ofthe insurance company fRIR2 8) 215 bit Phone no, ® 36% Faxno aa Policy no. RES Page) 8-5‘Type no. (Please see chart) eG (AEA) Colour Materal Brandname: Purchase cate me a eA ER Purchase price BESR uss an Quantity ca Avticle! tem ‘att Gender | Brans name, colour, material size and other descristion| Purchase date S81 TER Be RE: RAR ame Purchase price moe (Example 5h 7 ‘Sweater cs Female ‘Camey, brown, wool M Sze 28-Jan-07 & Pes eee 2007128 S880 3087 Total alain | ROE uss aa hereby declare thatthe information given inthis form and in the enclased documents is rue and complete, | acknowledge that Cathay Pacific reserves, its rights against me if attempt to make false claim. lalso acknowledge that the information willbe used for baggage tracing. baggage delvery, ‘baggage repair and clam handing, Such data may be transmitted to other Cathay Pacific offices, elevant government and enfore Cartars or the provice's of ancillary services in whatever country they may be located, for srular purposes. AAR SERS ADA PROTA IE AARNE ASSL ROR» MORELIA « ASNT LAPT FATS AG «RE « MI ALN I SRO HS ARMA ESR UI A A FERESURAT ABP RCA U « Plt A eRe RO SPADES + nent agencies, other Clamant’s signature BARAT Date 288 Poe? B=Baggage Identification Chart TFB Luggage/bags fik(T*8 / Fe Ov tit 03 _ EM 22_Wiui 220 Closes with ippers Types 20-29, (06 init O7 tami 23 il oa 2 (08 tai }[O9 tinea} [10 tan) 12 26 lini} |27 Ati] 28} [29 Miscellaneous articles #491 Mayhave protective cover, specify brand of article “TE GiteoRRaetn - aaiMneDtH ORT 3h ol 51 wninin | (52 lp ‘i 55 it eS 56 il 57 tit =< 4 G1 im 62 vn PT 3 gs Th tom [72 tn 75 Viet |81 ‘nimi 82 ‘ni 33 Nt 85 NN ‘ge ticle not shown (SSCS BQ ill | [GO Lum G2 waa | 93 VN | |G4 NA 5 imi 96 il 97 lumi I m7 99 jiu Popes B= A