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የስብሰባ ጥሪ (Extended to unknown date)
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የተሻሻለ የመመስረቻ ፅሑፍ (MOA)
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Marine Claims Notification Form
Insured Name
*
City
Tel.
*
Policy no(where branch the policy issued)
Type of Cargo
*
Date of Damage
Date of Discharge at Port
Voyage: From - To
*
Name and Address of Inland transporter
Name
Address
Wereda
Kebele
H.No
Name of Driver
Plate No: Truck
Trailer
Date of Departure from port
Date of Arrival
Air Way Bill
police report
Yes
No
Preliminary Survey Report (if any)
Preliminary Survey Report
Description & extent of Damage
Date of Notification
*
Signature & Seal
*
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