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APPLICATION FOR PREFERRING COMPENSATION CLAIMS
FOR
DAMAGE, SHORTAGE OR
LOSS OF GOODS/PARCELS
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Letter No: Dated: _______________
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To
The Chief Claims Officer,
S.C.Railway,
Secunderabad.
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Dear Sir,
Sub:
Claims for compensation : Invoice/Railway Receipt/Parcel Way Bill/ Luggage
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Ticket
No. _________________ from ________________ to _______________________
Under section 106 B and 192 of the Railways Act, 1989,
I prefer a claim on the_________________
__________________Railway, particulars of which are detailed
below.
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1.From __________________
(Station) to ____________________(Station)
via_______________
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2.Invoice and Railway
Receipt/Parcel Way Bill/Luggage Ticket No. ____________dated __________
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3.No. of packages and
description of consignment booked as shown in the Railway Receipt / Parcel Way Bill / Luggage
Ticket___________________________________________________________
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4 Name of the consignor __________________________________________________________
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5. Name of the consignee
_________________________. 6. Date of delivery ________________
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7. Details of shortage,
damage or loss _______________________________________________
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8.Full particulars of the contents of the missing or
damage package/packages showing the value of each article packed therein.
(Short or open delivery certificate, if any should be enclosed)
________________________________________________________________________________
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9.The amount claimed and how it is arrived at (The
original trade invoice or other proof of the value of the goods together
with a copy should be enclosed)
________________________________________________________________________________
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10.My/our title to the claim (A letter of the
authority from the endorsed consignee, if necessary, and the Railway
Receipt or Partial Delivery Certificate, original or certified copy, should
be enclosed) ________________________________________________________________________________
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11.Other remarks, if any
____________________________________________________________
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Encls: Beejuck/Traders invoice
Letter of authority, Subrogation etc.
Railway Receipt or Partial Delivery Certificate or
certified copy thereof Short or
open delivery certificate.
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Yours
faithfully
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(Full
Name & address)
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