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Policy Owner Details
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Phone No
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Address
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State
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Port Of Origin
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Destination
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Lien
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Details of Incident
Date of Incident (yyyy-mm-dd)
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Time of Incident
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Where Did the Incident Occur?
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Brief Details of Incident
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Pictures of Incident/Damaged Goods
All Attachments Must be In PDF or JPEG Format
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Upload Supporting Documents(if any)
Superintendent Report
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Statement of claim(sheet showing quantities and value of goods damaged/lost)
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Original Bill of Lading
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Original Suppliers Invoice and Packing List
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Original Discrepancy Certificate
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Original Delivery Waybill
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Original NPA T Form 38
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Customs Bill of Entry
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Estimate Of Claim
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Statement of Authenticity/Truth of Details Given Above (Please Tick Box).
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