Maritime Cargo Damage Claim Form
1. Claimant Information
Company Name
Contact Person
Address
Phone
Email
2. Shipment Details
Bill of Lading No.
Vessel Name
Voyage No.
Port of Loading
Port of Discharge
Date of Arrival
3. Cargo Details
Description of Cargo
Quantity/Weight
Container/Package No.
Nature of Damages
4. Claim Information
Date Damage Noticed
Estimated Loss (Value / Currency)
Supporting Documents (List)
Additional Comments
5. Declaration
Name
Position
Date
Signature