Customer Claim Form
Customer Name:*
Company Name:
Address:
Phone No:*
Email ID:
Date:*
Branch:*
GC No:*
GC Date:
Gen.DairyNumber:
Booking Branch:
Delivery Branch:
Booking Amt:
Claim Type:
No.of Pkgs
SNOItemNo Asper PkgListDamaged ArticleShortage ArticleDeclared Amt as Pkg List* Demand AmountRemarksActions
     Total:   
Documents Required:
Reason of claim: Proposed ClaimAmt:
Action Taken:
Claim Status:
Settled: Pending: Under Process:
Settlement Details:
Set.LtrNo.
Set.Date:
Set.Amt
Cs.No:
DataEntry Person: DataEntry Date: