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Notice of Loss
Notice of Loss
Ӧ֟Ǻ10457ᆵчѱύξ݊Ԣၡ126ဦ13ኴ
୍፝ܺጕǺ0800-077-568
!!
ၮᒡߥᓀ፝ҙፎਜ!
፝ൔਢߞጃǺclaim.service@hotains.com.tw
፝ൔਢǺ(02)2181-5091
Claim Form
༤ቪВයǺ ԃ Д В
烋
ㄑ ୷ +ߥᓀΓ! +ᖄ๎Γ!
! !
Ƽ ƽ ҁ Jotvsfe!obnf! Dpoubdu!obnf!
ᴉ ၗ +ߥൂဦዸ!
㧂 !
Qpmjdz!op/!
!!!!Jotvsfe!Efubjmt!
ḋ
ᖄ๎Ӧ֟!
炻
Beesftt!
ɍɍɍɍɍ!
妉
↗ +ᖄ๎ႝ၉! ဦዸ!
)!!!!*! !
⺃ Ufmfqipof!op/! Gbdtjnjmf!op/!
✩ Չႝ၉!
⪩ ! F.NBJM! !
Dfmm!qipof!op/!
宅
㑗 +ཞѨวғВ!
ˤ ԃ!!!!!!!Д!!!!!!!В!!!!!!!ਔ!!!!!!!ϩ!
ཞ Ebuf!pg!mptt0ebnbhf!
Ѩ ɍ!Нᔸ!Xbufs!ebnbhf!!!ɍ!ઇཞ!Csfblbhf!!!ɍ!ྈᅅ!Mfblbhf!!!ɍ!อϿ!Tipsubhf!!!!!!!!!!!
ᇥ
ܴ +ཞѨচӢ! ɍ!ځдǴፎ၁ॊ!Puifs-!qmfbtf!qspwjef!efubjmtǺ!
Dbvtf!pg!mptt0ebnbhf!!
!!!Obssbujwf!pg!mptt0ebnbhf!
!
+ނޑӜᆀ!
!
Dpnnpejuz!
+ނޑӸܫӦᗺ! ᖄ๎Γ Dpoubdu!obnfǺ!!!!!!!!!!!!!!!!
Beesftt!pg!tupsbhf! !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!ᖄ๎ႝ၉ Qipof!op/Ǻ!!!!!!!!!!!!!!!!!
+ཞѨኧໆǵ!
ႣཞѨߎᚐ!
Mptt!rvboujuz!'! !
ftujnbufe!mptt!
bnpvou!
+ҙፎᓀᅿ Bqqmjfe!Jot/! +ၮଌၗૻ!Usbotju!Jogpsnbujpo!
ډෝВ! ㊎学㒣
!!!!!ԃ!!!!!Д!!!!!В! ⹛ 㛯 㗌
Ebuf!pg!bssjwbm! 'DWHRIGLVSDWFK
ɍ!GPC!!!!!!ɍ!DJG!!!!!!ɍ!DGS!!!!!!ɍ!FYX!!!!!!ɍ!EEQ!!!
ຩܰచҹ!
ɍ!ځд PuifsǺ!
ɍ!ނၮᒡߥᓀ! Ufsnt!pg!tbmf!
!
!!!Nbsjof!Dbshp!Jot/!
ɍ!ӄᘕ!GDM0DZ!!!ɍ!ٳᘕ!MDM0DGT!!!ɍ!ޜၮ!Bjs!!!ɍ!זሀ!Fyqsftt!!!
ၮଌచҹ!
ɍ!ځд!PuifsǺ!
Usbotju!nfuipe!
!
澿 ፎӃ Fnbjm ගൂǵߥᓀൂǵว౻ǵးጃൂǵྣТځ܈д࣬ᜢЎҹǴٮҁϦљୖԵǴаߡࡌᔞೀǶ!
ɍ!ౢࢬᆕӝߥᓀ! ၮଌΓ0ૼڙΓ
!!!Qspqfsuz!Gmpbufs!Jot/! Dbssjfs0Cbjmff!
ߥًቷࠠ Nblf!'!npefm! ߥًًဦ Sfhp!op/!
ɍ!ނၮଌΓೢҺߥᓀ! ߥًԃҽ!Zfbs! Їᔏဦዸ Fohjof!op/!
!!!Gpsxbsefs!Mjbcjmjuz!Jot/!
ᎯᎭۉӜ!
ᎯᎭႝ၉ Qipof!op/!
Esjwfsȷt!obnf!
ɍ!ߥᓀΓ!!ɍ!୍0ߥжǺ! ፝ൂՏԏҹക! ୍0ߥжԏҹക! ߥᓀΓᇂക!
ଌ
ҹ ᖄ๎ႝ၉! !
Γ Fnbjm! !
ၗ ୍0ߥжᇥܴឯ;!
!
ၮᒡߥᓀ፝ҙፎਜᄤ፝ޕ.312813
ၮᒡߥᓀ፝!ޕ
൘ǵ ፝܌ሡЎҹ;!)Ѻ#Ή#!*ޣ
ҙፎᓀᅿ!
! ނၮᒡ! ౢࢬ
ނ
! ߥᓀ! ᆕӝߥ
! ၮଌ
ᓀ!
!!
Γ! ᇥ!!!!ܴ!
ԛ ! !ٳ ၮ! ኩ!
ೢҺ
!
ᘕ!
! ӄ!!!!!!!
!!!!!!!ז
ଌ! ਔ!
˚! ߥᓀ!
! ᘕ! !ޜሀ! ! ᓯ!
!፝!!܌ሡ!Ў!ҹ! ၮ! ύ! Ӹ!
፝ҙፎਜ)҅ҁ*!
2! Ή! ߥᓀΓᒃԾ༤ቪ٠ᇂകǶ!
Dmbjn!Gpsn!
3! ཞ೯ ޕOpujdf!pg!mptt! Ή! Ή! Ή! ! ! ! !
ว౻!
4! Ή! !
Dpnnfsdjbm!jowpjdf!
5! းጃൂ Qbdljoh!mjtu! Ή! !
ගൂ҅ҁ!
6! Ή! Ή! Ή! ! ! ! ȨזሀၮଌȩፎගٮȨނᛝԏൂȩǶ!
Psjhjobm!cjmm!pg!mpbejoh!
7! ߥൂ҅ҁ Psjhjobm!qpmjdz! Ή! Ή! Ή! ! ! ! !
2/ಭϦљǵੇᜢ܈ঊᓯϦљ໒ҥϐ٣ࡺ
ܴൂ Ebnbhf!SfqpsuǶ!
3/ૐޜϦљ໒ҥϐ౦தൔǶ!
Jssfhvmbsjuz!Sfqpsu!
4/ᘕ໒ҥϐᘕҬඹᡍԏൂǶ
ཞѨܴЎҹ! Frvjqnfou!Joufsdibohf!Sfdfjqu!
8! Epdvnfoubsz!fwjefodf! Ή! 5/ಭϦљ܈ૐޜϦљϐอڕܴ!
tvqqpsujoh!uif!mptt0ebnbhf! Tipsu!mboejoh!Dfsujgjdbuf!
6/ੇ٣ൔ Tfb!QspuftuǶ!
7/БൔਢܴǶ!
8/ځдຏ౦தϐගҬௗൂᏵǶ!
)ӵǺEfmjwfsz!Opuf-!Ubmmz!Tiffu-!
Fydfqujpo!Mjtu*!
9! ཞྣТ! Ή! Ή! Ή! Ή! Ή! Ή! хࡴނѦхးྣТǶ!
ڕྣТ Qjduvsf!gps!dbshp!
:! tupxbhf!cfgpsf!ejtdibshjoh! Ή! Ή! ! ! ! ! !
gspn!dpoubjofs!
ၮᒡߥᓀ፝ҙፎਜᄤ፝ޕ.312813
ҙፎᓀᅿ!
! ނၮᒡ! ౢࢬ
ނ
! ߥᓀ! ᆕӝߥ
! ၮଌ
ᓀ!
!!
Γ! ᇥ!!!!ܴ!
ԛ ! !ٳ ၮ! ኩ!
ೢҺ
!
ᘕ!
! ӄ!!!!!!!
!!!!!!!ז
ଌ! ਔ!
˚! ߥᓀ!
! ᘕ! !ޜሀ! ! ᓯ!
!፝!!܌ሡ!Ў!ҹ! ၮ! ύ! Ӹ!
!
21!ϣഌًՉૼၮൂ0ଌൂ! Ή! Ή! ! Ή! ! Ή!
22!অሽൂܴ܈ಒ! Ή! Ή! Ή! Ή! Ή! Ή! !
23!অว౻܈ԏᏵ! Ή! Ή! Ή! Ή! Ή! Ή! !
24!ౢҞᒵ! ! ! ! Ή! Ή! ! !
25!π٣ࡺၸൔ! ! ! ! Ή! Ή! ! !
26!БൔਢܴϷਜ!ڄ ! ! ! Ή! Ή! Ή! !
2/ᓯӸය໔วғϐཞѨǴፎගٮπӧ
ᙍܴǶ!
27!ӧᙍܴ! ! ! ! Ή! Ή! Ή!
3/ၮଌය໔วғϐཞѨǴፎගٮًљ
ᐒӧᙍܴǶ!
28!ϣഌًՉၮଌӝऊਜ! ! ! ! ! ! Ή! !
ًϐՉًइᒵ߄0Չًᒵ
29! ! ! ! ! ! Ή! !
Ꮤฝय़!
2:!ًљᐒՉǵᎯྣቹҁ! ! ! ! ! ! Ή! !
31!Mptt!tvcsphbujpo!sfdfjqu! Ή! Ή! Ή! ! ! ! !
፝ීӕཀਜ)҅ҁ*!
32! ! ! ! Ή! Ή! Ή! ፎຏܴීڙΓࣁߥᓀΓ܈ЬǶ!
Bddfqu!gpsn!
33!کှਜ)҅ҁ*! ! ! ! ! ! Ή! !
2/Ѝ౻ቹҁ܈๏бԏᏵǴ٠ፎߥᓀΓ
ϷЬᛝӜᇂകǶ!
34!کှߎϐ๏бܴ! ! ! ! ! ! Ή!
3/ऩคǴߥᓀ፝ීᔈҗߥᓀΓܭȨ፝
ීӕཀਜȩࡰۓ๏бЬǶ!
35!ሌՉӸᄙ࠾य़ቹҁ! Ή! ȨѦჾбීȩፎගٮȨCbol!efubjmtȩ!
ځдЎҹຎਢሡाќՉගٮ
ϐǴӵǺਜ)҅ҁ*ǵးᘕ
36! ྣǵଛᑭკǵрၸዳख़ໆ Ή!
ܴǵൔᜢൂǵᆬೢ᠘ۓൔǾ
!
ၮᒡߥᓀ፝ҙፎਜᄤ፝ޕ.312813
ມǵ፝ᇥܴᆶݙཀ٣Ǻ!
ǵӄᘕၮଌ!
ߥᓀΓځ܈жΓǴӵൔᜢՉǵπቷঊᆅӧᘕග܈ԏਔᔈݙཀΠӈ٣Ǻ!
2/ᔠᘕ࠾చࢂցֹǴԖคઇᚯ౩ၞǴࢂցමᎁඤǴ࠾చဦዸࢂցᆶගൂȐCjmm!pg!
Mbejohȑ܌ၩ࣬಄ǹऩᘕၸੇᜢܜᡍǴ߾Ԗੇᜢϐ࠾చǶ!
3/ᔠᘕѦᢀԖคཞᚯ܈ឌᇑǹӵԖઇཞǴൔᜢՉᔈӛًљᐒ܈ᘕΓڗຏᘕ
ઇཞϐȨᘕҬඹᡍԏൂȩ)Frvjqnfou!Joufsdibohf!SfdfjquǴᙁᆀ FJS*Ǵ٠ܭҬਔ
ଌҬЬǶ!
4/໒ᘕ܈ԏਔǴᔈाًљᐒ܈ᘕΓӕᔠࡕӆᛝԏǶ!
Βǵٳᘕၮଌ0ޜၮၮଌ!
2/ ߥᓀΓځ܈жΓǴӵൔᜢՉǵπቷঊᆅӧᘕ)DGT*0ૐޜၮઠ)Bjs!dbshp!
ufsnjobm*ගਔᔈݙཀΠӈ٣Ǻ!
2* ᔠނѦхးࢂցֹӳǴΠ࠾αጤԖคख़࠾Ƕ!
3* ᔠख़ໆԖค౦தǶ!
4* ᔠጃ)ළ݈*ኧໆࢂց҅ዴǶ!
5* ᔠ࿘ናࡰҢᏔࢂցᡂՅǶ!
6* ᔠࢂނցԖᡍᜢǶ!
7* ނӵԖॊ౦தǴᔈہፎൔᜢՉΓ܈ሦљᐒҥջӛಭϦљ0ૐޜϦљ܈ᘕ!
Γ0ૐޜၮઠڗԖຏނઇཞϐཞѨܴЎҹǴӵǺಭϦљ܈ᘕ)ሡ
ӕၮଌΓᛝക*ᛝวϐ٣ࡺܴൂ)Ebnbhf!Sfqpsu*ǵૐޜϦљ܈ૐޜၮઠᛝวϐ౦
தൔ߄)Jocpvoe!Dbshp!Jssfhvmbsjuz!Sfqpsu*ǵҹኧอϿϐอڕܴ)Tipsu.mboejoh!
Dfsujgjdbuf*܈҂ଌၲ)Opo.efmjwfsz*ܴЎҹǴӕਔҥջ೯ߥޕᓀϦљǶ!
3/ ߥᓀΓӧԏਔǴᔈाًљᐒӕᔠࡕӆᛝԏǶ!
ΟǵߥᓀΓӧ໒ᘕ܈ԏਔǴऩวނอϿǵઇཞ܈НᔸਔǴᔈܭගԏᏵуຏཞѨݩރǴ٠
ߥ੮Ǵӕਔҥջ೯ߥޕᓀϦљǶ!
ѤǵऩܨނጃమᗺࡕǴωวཞѨǴፎӃྣܡӸ)ߕԖВයϐྣТኧ*Ǵ٠ߥ੮ڙཞނϷхးǴ
ӕਔҥջ೯ߥޕᓀϦљǶ!
ϖǵߥᓀΓӧග܈ԏวཞѨਔǴੇၮᔈܭΟВϣǵޜၮᔈܭΜѤВϣӛၮଌΓ0܍ᡙၮ
ଌΓวཞ೯)ޕOpujdf!pg!Mptt*፝Ǵ٠ाၮଌΓ0܍ᡙၮଌΓࢴہж߄ӕϦǴаߥ੮
፝ճǶ!
ϤǵၶԖౢϐ྄ཞྐ܈ѨǴፎаਜय़ӛჹܭ၀ཞѨॄԖೢҺϐၮଌΓǵૼڙΓځ܈дಃΟΓ
ा፝ᓭǴаߥ੮፝ճǶ!
ΎǵፎӃFnbjmගൂǵߥᓀൂǵว౻ǵးጃൂǵྣТځ܈д࣬ᜢЎҹǴٮҁϦљୖԵǴаߡࡌᔞ
ೀǶ!
ΖǵҁϦљܭௗᕇൔਢࡕǴஒຎਢሡाہፎϦϦљڐշೀǶ!
ΐǵ ߥᓀΓ൩ځೢҺࣁ܌ϐ܍ᇡǵکှ܈፝ᓭǴҁϦљϐୖᆶ܈٣ӃӕཀǴց߾ҁϦљஒό
کڙှߎᚐϐऊ״ǶՠߥᓀΓԾᜫॄᏼޣόӧԜज़Ƕ!
Μǵ ऩԖಃΟΓჹԜཀѦ٣ࡺ٩ݤᔈॄ፝ᓭೢҺޣǴߥᓀΓόளჹ၀ಃΟΓխନೢҺǵܙకճ
܈ԾՉکှǴߥᓀΓᔈߥ੮܌ԖࡓݤଓນϐճǶ!
ၮᒡߥᓀ፝ҙፎਜᄤ፝ޕ.312813
ΜǵፎߥᓀΓᏃໆܭ٣ࡺวғࡕΟΜВϣஒॊ፝ၗၲҁϦљǴаߡࣁॺךாೀԜਢǶ!
ΜΒǵ፝ීԖիඤϐԵໆਔǴऩߥൂคձऊۓǴҁϦљջ٩ཞѨวғВϐիඤਡᆉϐǶ!
ΜΟǵбීБԄǺ!
)* ᘕᘚሦීǺፎߥᓀΓܭௗᕇҁϦљ୍೯ࡕޕǴឫᆶکှਜ܌ᇂ࣬ӕϐϦљελ
കٰሦڗ፝ීЍ౻Ƕ!
)Β* ༊ීǺҁϦљ୍ஒ፝ී༊ΕߥᓀΓۓࡰ܌ϐሌՉဦǶ!
ΜѤǵ፝ී፝бǴፎߥᓀΓᛦమҁߥൂϐ܌ԖߥǴаճбීբϐՉǶ!
ၮᒡߥᓀ፝ҙፎਜᄤ፝ޕ.312813
!!!!
Dear Sirs,
We regret to inform you that the above cargoes have sustained severe loss/damage upon
taking delivery. We or our surveyor will contact you for arranging the necessary joint
survey. Kindly assign your representative or surveyor to joint our survey procedure. If you
do not want to appear in the survey, please let us know, otherwise the extent or cause of
loss shall be ascertained solely upon our or our surveyor’s findings, and your right of
contending not being notified will therefore be prejudiced.
We also reserve all the right to file a formal claim when the details of loss is ascertained.
Yours faithfully,
________________________ ___________________________
Sender)วЎൂՏ.ፎᇂϦљελക*! Carrier/Forwarder)ԏҹΓፎᛝӣ*
Ȝഢຏᇥܴȝ ǺၮଌΓऩคᛝӣਔǴፎ!ϦљዴᇡԜ೯ڄޕς!!!ܭԃ!!!!Д!!!!!В!
!!!ਔ!!!!ϩǴҗϒ!`````````````````!Ϧљ```````````````Ӄғ0λۆǴ
٠җ!Ϧљႝ၉၌ዴჴၮଌΓԏّคᇤǶ!
کੀౢߥނᓀঁΓၗޕ٣
!!!!
ҁϦљȐکੀౢߥނᓀިҽԖज़Ϧљȑ٩ᏵঁΓၗߥៈݤȐаΠᆀঁၗݤȑಃϤచಃΒǵಃΖచಃ)ӵࣁ໔ௗᇆϐঁ
Γၗ߾ࣁಃΐచಃ*Ϸځдঁၗ࣬ᜢೕۓǴх֖ՠόज़ܭȨኻ࿉ঁΓၗߥៈೕ߾ȩǴӛ! ѠᆄޕΠӈ٣Ǵལፎ! Ѡ
ᆄ၁᎙Ǻ
ǵ ᇆϐҞޑǺ
()ౢߥᓀ)٩ߥᓀݤзೕۓᒤϐౢߥᓀ࣬ᜢ୍*Ƕ!
(Β)Γߥيᓀ)٩ߥᓀݤзೕۓౢߥᓀЬᆅᐒᜢёᒤϐΓߥيᓀ࣬ᜢ୍*Ƕ!
(Ο)ځдᔼӝܭᔼฦҞ܈ಔᙃകำ୍ۓ܌Ƕ!
ΒǵᜪձǺ
Ԗёૈх֖ՠόज़ܭǺۉӜǵيϩӷဦǵៈྣဦዸǵрғԃДВǵՐ֟ǵᖄ๎БԄǵஆ࠷ǵৎǵ௲ػǵᙍǵ୍ݩǵ
ޗᇡӕǵᔮЎϯǵՏၗǵᆛၡᘤំᏔ dppljft ᆶձዸ)JQ Տ֟*!ǵϷځдளаޔௗ܈໔ௗБԄঁ܈ӭঁձ၀
ঁΓϐၗǹҭёૈࢂ!Ѡᆄਜय़ӕཀᇆǵೀ܈ճҔϐੰᐕǵᙴᕍǵ୷ӢǵғǵЈϷ଼நᔠঁΓၗǶ!
ΟǵঁΓၗٰྍǺ!
()ाߥΓ/ߥᓀΓǶ
(Β)љݤᏦᐒᜢǵڐૼہշೀ፝ϐϦΓ܈ᐒᄬǶ
(Ο)٣ΓϐۓݤжΓǵᇶշΓǶ
(Ѥ)Ӛᙴᕍଣ܌Ƕ
(ϖ)ᆶಃΟΓӅӕՉᎍǵҬϕၮҔ࠼Њၗǵӝբቶᜢ߯ǵܭ܈ҁϦљӚ୍ϣૼہ܌۳ٰϐಃΟΓǶ
ѤǵঁΓၗճҔϐය໔ǵჹຝǵӦϷБԄ
()ය໔ǺӢՉ୍܌ѸϷݤзೕۓᔈࣁߥӸϐය໔Ƕ
(Β)ჹຝǺ
1.ҁϦљǵᆶҁϦљᛝुӝբቶࠨऊϐߥᓀжΓ/ߥᓀइΓǵӢᒤౢߥᓀ࣬ᜢ୍ሡाϐಃΟБǶ
2.ҁϦљϐᕴϦљǵϩϦљǵ೯ૻೀǵ܌ឦიϐ୯ϣѦᜢᖄҾǵύ҇୯ౢߥނᓀӕϦǵύ҇୯Γტߥᓀ
ӕϦǵიݤΓߥᓀ٣วύЈǵიݤΓߥᓀӼߎ୷ۓǵიݤΓՐӻӦߥᓀ୷ߎǵიݤΓًؓҬ೯٣ࡺ
ձံᓭ୷ߎǵიݤΓߎᑼຑύЈǵიݤΓߎᑼᖄӝቻߞύЈǵიݤΓᖄӝߞҔьύЈǵѠ౻ᏵҬඤ܌ǵߎ
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