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
[email protected]
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
