Baggage Inventory & Claim Form

We are sorry your luggage was not available after your recent flight. Please accept our apology for the inconvenience this caused. Everything possible will be done to locate and
return your property to you promptly. Successful tracing and resolution of this claim depends on prompt completion and return of this form for each bag that is missing.

Personal Details GRULA56153

Last Name / Surname First Name

SILVA BIANCA
Language Passport Number
PORTUGUES PSPT FT182812
Class of Service / Status Frequent Flyer Number Frequent Flyer Airline
LA40870746847 LAT
Contact Information

Permanent Phone 1 Cell / Mobile Phone 1

5511945066518AM 5511945066518
Temporary Phone 1

Email Address 1
BIANCA.BIAHSILVA@GMAIL.COM
Email Address 2

Permanent / Home Address

House Number Street Name Apartment

7 7 CLAREMANT ROAD
City State Country Zip / Postal Code
HOWTH DUBLIN IE D13

Temporary Address

Hotel Name - c/o

House Number Street Name Apartment

RUA IAPO N 554 CASA VERDE
City State Country Zip / Postal Code
SAO PAULO SP IE 02512020
This Address Is Valid Until
MAR 28, 2020

Passenger Flight Information

Airline Flight Date Origin Destination

BA 837 MAR 17, 2020 DUB LHR
LA 8085 MAR 17, 2020 LHR GRU

Ticket Number(s)
9572120041385
Number of Passengers Travelling Together
0
After you checked in your baggage, did you travel on the original flights?

If No, state your original itinerary.

General Baggage Information

Bag Identification Information

Name / Other Name on Bag Initials on Bag

House Number Street Name Apartment

 City State Country Zip / Postal Code

Phone 1 on Bag

Travel Information

Total Bags Checked Total Bags Missing

1 1
Tag Numbers of Missing Bag(s)

BA598401

Did you pay excess baggage charges? If so, please provide the details.
Details

Where Did You Check-in Your Bag(s)

CHECK-IN
COUNTER
If you purchased a declaration of higher value, please complete the following.
Declared Higher Value and Currency

Arrival Information

Did you attempt to claim your baggage on arrival

If you had to clear customs at any point of transfer, was your baggage available
If no, did you file a report at that transfer station

If yes, state the file reference:

Where Was Your Baggage Last Seen

Airport and/or Location

Individual Bag Details

1. Missing Bags

Color Type Material Elements Basic Elements

RED UPRIGHT DESIGN SOFT RIGID WHEELS/ROLLERS
MATERIAL
External Elements Estimated Bag Weight Purchase Date Price / Cost of Bag
NO EXTERNAL 22.0 KG
DESCRIPTIVE ELEMENTS
Brand Information Exterior Markings
YINS RED/GREY
Lock Code

Bag Contents
Article No. Color, Size, Material, Brand Gender Where Purchased Date Purchased Cost
COAT 1 STRADIVARIUS FEMALE IRELAND - 45.0 EUR
COSMETICS 10 - FEMALE IRELAND - 110.0 EUR

FOOD 2 GUINESS NONE IRELAND — 4.0 EUR

FOOTWEAR 4 SORT FEMALE IRELAND — 120.0 EUR

HANDBAG 1 — FEMALE IRELAND — 20.0 EUR

PIJAMA 1 — FEMALE IRELAND — 15.0 EUR
JAMPSUIT 2 H&M FEMALE IRELAND — 38.0 EUR
SHIRT 4 —- FEMALE IRELAND —- 20.0 EUR
SKIRT 2 H&M FEMALE IRELAND — 50.0 EUR
TROUSERS 5 —- FEMALE IRELAND —- 120.0 EUR
DRESS 2 — FEMALE IRELAND —- 30.0 EUR
BLAZER 1 PRIMARK FEMALE IRELAND — 28.0 EUR
SHORTS 2 — FEMALE IRELAND — 30.0 EUR
BELT 2 — FEMALE IRELAND — 20.0 EUR
 HEADWEAR 1 —- FEMALE IRELAND — 10.0 EUR

GIFT 5 — FEMALE IRELAND — 50.0 EUR

Total Claim Amount

Additional Information

Additional Information