Marine Cargo Loss Survey Form
Survey Reference Number
Date of Survey
Insured Details
Insured Name
Contact Number
Address
Cargo Details
Description of Cargo
Cargo Quantity
Packaging Type
Value of Cargo
Voyage Details
Origin
Destination
Vessel Name / Voyage No.
Bill of Lading Number
Loss Details
Date & Time of Loss
Place of Loss
Narrative/Description of Loss
Inspection & Findings
Inspection Conducted By
Nature and Extent of Damage/Loss
Remarks
Supporting Documents
List of Documents Received
Surveyor's Details
Surveyor Name
Surveyor Signature
Date