Claim Form Date Filed MM slash DD slash YYYY Claim Amount (Specify Currency)(Required) KDExpress Waybill #(Required) Is hearby claim for(Required) Lost Damage Missing Items Tên Người Gửi(Required) Tên Họ Tên Người Nhận(Required) Tên Họ Địa Chỉ Người Gửi(Required) Tên Đường Địa Chỉ 2 Thành Phố Quận/ Huyện ZIP / Postal Code United StatesBonaire, Sint Eustatius and SabaBrunei DarussalamCabo VerdeCocos IslandsCongo, Democratic Republic of theCongoCôte d'IvoireCuraçaoCzechiaHoly SeeKorea, Democratic People's Republic ofKorea, Republic ofLao People's Democratic RepublicPalauPalestine, State ofRéunionRussian FederationSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint MartinSao Tome and PrincipeSint MaartenSouth Georgia and the South Sandwich IslandsSyria Arab RepublicTanzania, the United Republic ofTürkiyeUnited KingdomUS Minor Outlying IslandsViet NamVirgin Islands, BritishVirgin Islands, U.S.American SamoaGuamNorthern Mariana IslandsPuerto RicoAfghanistanÅland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandColombiaComorosCook IslandsCosta RicaCroatiaCubaCyprusDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorwayOmanPakistanPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarRomaniaRwandaSaint Kitts and NevisSaint LuciaSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandTaiwanTajikistanThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUruguayUzbekistanVanuatuVenezuelaWallis and FutunaWestern SaharaYemenZambiaZimbabwe Quốc Gia Địa Chỉ Người Nhận(Required) Tên Đường Địa Chỉ 2 Thành Phố Quận/ Huyện ZIP / Postal Code United StatesBonaire, Sint Eustatius and SabaBrunei DarussalamCabo VerdeCocos IslandsCongo, Democratic Republic of theCongoCôte d'IvoireCuraçaoCzechiaHoly SeeKorea, Democratic People's Republic ofKorea, Republic ofLao People's Democratic RepublicPalauPalestine, State ofRéunionRussian FederationSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint MartinSao Tome and PrincipeSint MaartenSouth Georgia and the South Sandwich IslandsSyria Arab RepublicTanzania, the United Republic ofTürkiyeUnited KingdomUS Minor Outlying IslandsViet NamVirgin Islands, BritishVirgin Islands, U.S.American SamoaGuamNorthern Mariana IslandsPuerto RicoAfghanistanÅland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandColombiaComorosCook IslandsCosta RicaCroatiaCubaCyprusDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorwayOmanPakistanPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarRomaniaRwandaSaint Kitts and NevisSaint LuciaSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandTaiwanTajikistanThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUruguayUzbekistanVanuatuVenezuelaWallis and FutunaWestern SaharaYemenZambiaZimbabwe Quốc Gia List of Goods(Required)Goods DescriptionQuantityValueWeight of each unit Add RemoveClaim must be supported by by a detailed statement showing how. the amount was determined. Included description of item such as color, size, marking ect.Total claim amount(Required) Package Type(Required) Carton/Styrofoam Box Pallet Crates Goods packed by(Required) Shipper KDExpress Agent Was the Goods(Required) New Used Required documents KDExpress receipts or proof of payment Invoices of items Repair estimation if available Statement of abnormal package when received Pictures of damaged item, boxes upon received Other documents to support claim Note: Claim must be supported by the following documents. Select that apply. Failure to include sufficient documentation may be ground for denial of your claim and delay conclusion of claim. KDExpress reserves right to request any additional documents not listed below.Did you purchase KDExpress Declared Value Insurance?NoYesClaim payable to: Tên Họ Company Address Tên Đường Địa Chỉ 2 Thành Phố Quận/ Huyện ZIP / Postal Code United StatesBonaire, Sint Eustatius and SabaBrunei DarussalamCabo VerdeCocos IslandsCongo, Democratic Republic of theCongoCôte d'IvoireCuraçaoCzechiaHoly SeeKorea, Democratic People's Republic ofKorea, Republic ofLao People's Democratic RepublicPalauPalestine, State ofRéunionRussian FederationSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint MartinSao Tome and PrincipeSint MaartenSouth Georgia and the South Sandwich IslandsSyria Arab RepublicTanzania, the United Republic ofTürkiyeUnited KingdomUS Minor Outlying IslandsViet NamVirgin Islands, BritishVirgin Islands, U.S.American SamoaGuamNorthern Mariana IslandsPuerto RicoAfghanistanÅland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandColombiaComorosCook IslandsCosta RicaCroatiaCubaCyprusDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorwayOmanPakistanPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarRomaniaRwandaSaint Kitts and NevisSaint LuciaSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandTaiwanTajikistanThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUruguayUzbekistanVanuatuVenezuelaWallis and FutunaWestern SaharaYemenZambiaZimbabwe Quốc Gia PhoneEmail File Kéo thả tài liệu ở đây hoặc Lựa chọn từ thư mục Dung lượng tối đa: 5mb, Số lượng tối đa: 10.. 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