Please fill this claim form (This form can be used for up to 6 passengers) No win No FEE Passenger (1) First name (as in booking) Surname (as in booking) Passport number (If Israeli write Teudat Zehut) PassportTeudat Zehut Date of Original Flight Departure City/Airport Final Destination City/Airport Please make sure you have flight details of Original FlightIf booked by travel agent look out for the PNR on your documantaion. Flight number Reservation code (PNR) Airline Original Departure time Original Arrival time Actual Arrival time Your Address What would you like to claim for? Please check all relevant claims Compensation {up to 600€ / 3,440₪) per passenger.RefundCost of alternative way homeAccomodation / HotelFoodTransport to & from AirportBroken luggageDelayed luggageOther Description of delay/cancelation. As well as any information which may be important in regard to your claim. Add Passenger (2)NoYes First name (as in booking) Surname (as in booking) Passport number (If Israeli write Teudat Zehut) PassportTeudat Zehut New passenger status —Please choose an option—Child (under 16)Adult (Above 16) Does new passenger have the same booking details—Please choose an option—YesNo Flight number Reservation code (PNR) Airline Date of Original Flight Add Passenger (3)NoYes First name (as in booking) Surname (as in booking) Passport number (If Israeli write Teudat Zehut) PassportTeudat Zehut New passenger status —Please choose an option—Child (under 16)Adult (Above 16) Does new passenger have the same booking details—Please choose an option—YesNo Flight number Reservation code (PNR) Airline Date of Original Flight Add Passenger (4) NoYes First name (as in booking) Surname (as in booking) Passport number (If Israeli write Teudat Zehut) PassportTeudat Zehut New passenger status —Please choose an option—Child (under 16)Adult (Above 16) Does new passenger have the same booking details—Please choose an option—YesNo Flight number Reservation code (PNR) Airline Date of Original Flight Add Passenger (5)NoYes First name (as in booking) Surname (as in booking) Passport number (If Israeli write Teudat Zehut) PassportTeudat Zehut New passenger status —Please choose an option—Child (under 16)Adult (Above 16) Does new passenger have the same booking details—Please choose an option—YesNo Flight number Reservation code (PNR) Airline Date of Original Flight Add Passenger (6)NoYes First name (as in booking) Surname (as in booking) Passport number (If Israeli write Teudat Zehut) PassportTeudat Zehut New passenger status —Please choose an option—Child (under 16)Adult (Above 16) Does new passenger have the same booking details—Please choose an option—YesNo Flight number Reservation code (PNR) Airline Date of Original Flight Minmize your files FREE >> Our charge: If the value is over £1,000, the commission rate is 20% for the amount above £1,000. For the first £1,000 of your claim's value, We charge 25% as commission (minimum fee £50). If legal action is required, the fee will be 40% of the amount recovered [minimum £200]. No win No FEE I have read and agree to the Terms and Conditions and Privacy Policy By checking this box, you certify that the information provided is accurate, not misleading, and that all documents are authentic. You also certify that you have permission to complete this form on behalf of any other passengers listed. You agree that third parties acting on our behalf may access the information to process claims. Beisee's terms, conditions, and privacy policy apply. Clear
