- SKCL

FREIGHT LOSS/DAMAGE PRESENTATION

* Fields with red asterisks are required for cliams submission. Please complete required fields.

SKCL BL No *

Claimant Ref No.

Vessel Name
Vessel ATD	Vessel ATA

Port of Loading			Country *
Port of Discharge			Country *

Type of Claim * Partial Shortage Total Shortage Damage Other	Were the articles * New Used
Detailed Statement showing how amount claimed is determined: Include number and description of articles, if only a portion of the shipment is lost or damaged, indicate how many pieces in total shipment (i.e. 1 lost out of 10). Clearly describe Nature and Extent of damage. Show Actual cost of goods. Show all discounts, allowances & salvage. Indicate amount claimed.
Description (50 Character Max) *	Commodity *	Claim $

Is the damaged freight repairable?

Yes No
If No. Why?

Freight Charges Claimed

Salvage Value

Unknown None Other

Packaged Weight(lbs/kgs)

Total Claim(s)

Were outer containers damaged? Yes No	No. of outer containers damaged	Extent of damage to outer containers
Name of individual notified of Loss / Damage	Carrier Affiliation	City / Branch Office
Date and time of notification	Method of notification Web Fax In Person Telephone	Date Freight Inspected

Remarks (Explain the absence of any pertinent documentation - 250 Character Max)

The following Certification Must be completed by the Claimant

The Foregoing statement of facts is herby certified to as correct

Company *

Person Filing *

Address / P.O. Box *

Telephone No. *

City / State / Zip *

Email *

Date *

Check the appropriate supporting documents. Please note: please attach the supporting documents to this form using the file attachment upload section below. You will also be able to attach the supporting documents to an email after you submit this form. Please scan and e-mail or otherwise attach to the email to prevent processing delays.

Before Continuing, please verify all information is correct.
By submitting this form you are asserting the foregoing statement of facts is hereby certified as to correct and that your company is the party at a loss.