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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 BOSAF36855
Last Name / Surname
AMEERALI
First Name
MUSTANSIR
Title
MR
Initials
MA
Language

Passport Number
N2645669
Occupation

Class of Service / Status


ECONOMY
Frequent Flyer Number

Frequent Flyer Airline

Contact Information
Permanent Phone 1

Permanent Phone 2

Cell / Mobile Phone 1


2199168279
Cell / Mobile Phone 2

Temporary Phone 1

Temporary Phone 2

Fax 1

Fax 2

Email Address 1
MUSTANSIR.AMEERALI@GMAIL.COM
Email Address 2

Permanent / Home Address


House Number

Street Name
357 GREENWICH STREET
Apartment
4
City
VALPARAISO
State
INDIANA
Country
US
Zip / Postal Code
46383

Mailing Address (If different from permanent/home Address)


House Number

Street Name

Apartment

City

State

Country

Zip / Postal Code

Temporary Address
Hotel Name - c/o

House Number

Street Name

Apartment

City

State

Country

Zip / Postal Code

This Address Is Valid Until

Passenger Flight Information


Airline Flight Date Origin Destination
AF 338 AUG 15, 2014 CDG BOS



Ticket Number(s)
NA
Number of Passengers Travelling Together

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

Phone 2 on Bag

Bag Insurance
Insurance Company Name

House Number

Street Name

Suite

City

State

Country

Zip / Postal Code

Travel Information
Total Bags Checked
2
Total Bags Missing
2
Tag Numbers of Missing Bag(s)
AF081990 AF081989

Did you pay excess baggage charges? If so, please provide the details. NO
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 YES
If you had to clear customs at any point of transfer, was your baggage available YES
If no, did you file a report at that transfer station NO
If yes, state the file reference:

Where Was Your Baggage Last Seen


Airport and/or Location
PARIS
Individual Bag Details
1. Missing Bags
Color
RED
Type
UPRIGHT DESIGN SOFT
MATERIAL
Material Elements
NO EXTERNAL
DESCRIPTIVE ELEMENTS
Basic Elements
NO EXTERNAL
DESCRIPTIVE ELEMENTS
External Elements
NO EXTERNAL
DESCRIPTIVE ELEMENTS
Estimated Bag Weight
23.0 KG
Purchase Date

Price / Cost of Bag


80.0 USD
Brand Information

Exterior Markings
M.A INITIALS, YELLOW RIBBON
Lock Code
102
Bag Contents
Article No. Color, Size, Material, Brand Gender Date Purchased Cost
BOOKS 1 SACRED GEOMETRY,
AUTOBIOGRAPHY OF A YOGI, SPEED
READING
50.0 USD
FOOD 2 GARLIC PASTE, GINGER PASTE,
SEENI SAMBOL, BRINJAL SAMBOL
40.0 USD
SUIT 1 BLACK SUIT 100.0 USD
POWDERS 1 CURRY, CHILLI, CHICKEN POWDERS

20.0 USD
SHIRTS 6 GREY,PINK, WHITE AND OTHER
COLORS
150.0 USD
PANTS 1 GREY 30.0 USD
T-SHIRTS 10 DIFFERENT COLORS AND STYLES 150.0 USD
SHORTS 3 BROWN, WHITE, GREY 90.0 USD
SHOES 1 BROWN WITH ZIP AND SPORT
SHOES
120.0 USD
1 BELT 1 BRANDED BELT 20.0 USD
BOXERS 5 CALVIN KLIEN 40.0 USD
BLANKET 1 RED 30.0 USD
SOCKS 5 BLACK 15.0 USD
2. Missing Bags
Color
BLACK
Type
UPRIGHT DESIGN SOFT
MATERIAL
Material Elements
NO EXTERNAL
DESCRIPTIVE ELEMENTS
Basic Elements
NO EXTERNAL
DESCRIPTIVE ELEMENTS
External Elements
NO EXTERNAL
DESCRIPTIVE ELEMENTS
Estimated Bag Weight
23.0 KG
Purchase Date

Price / Cost of Bag

Brand Information

Exterior Markings
M.A RED STRIPES, RED GREEN RIBBON
Lock Code
102
Bag Contents
Article No. Color, Size, Material, Brand Gender Date Purchased Cost
ELECTRONICS
Total Claim Amount
1200.0 USD
Additional Information

Have You Reported the missing bag(s) to another airline?


Have You Reported?
NO
Airline

City / Airport

Have You or A Family Member Ever Had Another Baggage Claim With Any Airline?
Have You Claimed Before?
NO
Date of Claim

Airline Name

Additional Information

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