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  • Self Declaration Form

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    Saugat Modak
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    The document is a letter to Cleartrip Pvt Ltd regarding a claim settlement for a canceled trip with Trip ID 230612216966 scheduled for July 22, 2023 to GAU. The letter declares that the person undergoing medical treatment is the traveler's family member and provides their relationship. It includes a copy of government issued identification for the patient.

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    self-declaration-form

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    The document is a letter to Cleartrip Pvt Ltd regarding a claim settlement for a canceled trip with Trip ID 230612216966 scheduled for July 22, 2023 to GAU. The letter declares that the person undergoing medical treatment is the traveler's family member and provides their relationship. It includes a copy of government issued identification for the patient.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    23 views1 page

    Self Declaration Form

    Uploaded by

    Saugat Modak
    The document is a letter to Cleartrip Pvt Ltd regarding a claim settlement for a canceled trip with Trip ID 230612216966 scheduled for July 22, 2023 to GAU. The letter declares that the person undergoing medical treatment is the traveler's family member and provides their relationship. It includes a copy of government issued identification for the patient.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    To,

    Cleartrip Pvt Ltd.,


    9th floor, Tower A
    Embassy Tech Village, Devarabeesanahalli, ORR,
    Bangalore - 560103

    Dear Sir/Madam,

    This is regarding settlement of claim against Trip ID _____________________


    230612216966 , Where I was
    scheduled to travel to ____________________(destination)
    GAU on ______________
    22/07/23 (Date)I
    hereby declare that the Person undergoing Medical Treatment is related to me and is my
    _______________________________
    me (Relationship)

    Attached is the copy of Govt Issued Identification for the person undergoing treatment.

    Thanks,

    Name ________________________
    SAUGAT MODAK

    Signature SaugatModak
    ____________________ Date 22/07/22
    ________________

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