Customer Account Information

Customer Name: Customer Account Number: Customer Email Address: Waybill Number: Waybill Date: Type of Claim:

Select the type of claim you are submitting

Non-delivery of total consignmentShort delivery of full packagesShortage from packages (Pilferage)Loss due to hijackingDamagesItems returnedOther Details or description of the incident or how the loss occurred: Claim Amount in South African Rands:

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Upload the following documents:

A copy of the endorsed waybill

(3MB file size limit)

Any photos showing damages to the outer packing and contents

(3MB file size limit)

Copy of invoice

(3MB file size limit)

Dated bank letter confirming banking details (not older than 30-days)

(3MB file size limit)

Any other supporting documents to substantiate your claim

(3mb file size limit)

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Claimant Information

I confirm that all information presented and attached to this claim is true and correct Claimant's Name: (required) Claimant's Address: (required) Claimant's Signature: (required) Claimant's Mobile Number: Claimant's Office Number

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