Create Form

LIFESTYLE CLAIM FORM

This form to be used for a single claim only

All details must be completed in full for claim to be assessed. FOB credit value will be given to single items only.
Full suites will not be credited for single item damages.

CLAIM DATE *
E.g., 21/07/2018
Purchase Date: *
E.g., 21/07/2018
Container ETD: *
E.g., 21/07/2018
USD$

IMAGE UPLOAD

  •    All images must be in JPG format and uploaded in the section below
  •    Please ensure that images and faults are displayed clearly
  •    Claims cannot be processed without the requested images
Files must be less than 8 MB.
Allowed file types: png gif jpg jpeg.
Files must be less than 8 MB.
Allowed file types: png gif jpg jpeg.
Files must be less than 8 MB.
Allowed file types: png gif jpg jpeg.

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