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MISSING ARTICLE RECEIPT
October 12, 2016
Dear American Airlines Customer,
On behalf of American Airlines, please accept our apologies for the missing article(s) from your baggage. For reimbursement consideration, it will be necessary to also complete a passenger Property Questionnaire (PPQ) that is available from the website below:
Additionally, you can obtain this form at any American Airlines airport location from the Baggage Service Office. To facilitate our resolution of your claim, it is necessary that you complete and return the PPQ to us promptly.
Please fax or mail the Passenger Properb' Questionnaire to the addressffax below with the appropriate documentation required. One of our Baggage Specialists will contact you via postal mail within 15 business days from receipt of
Central Baggage Resolution Ofice - Claims 4000 East Sky Harbor Blvd.
Phoenix, AZ 85034
If you require assistance during this process, you may contact us at:
AMERICAN AIRLINES BAGGAGE CALL CENTER: 1-800-535-5225
For customers traveling in Europe, please contact us at: 00-800-2456-7890.
Customer Baggage File Information:
File Number: ORFAA01322435
Date: 10/12/2016 20:37
Location Reported: Norfolk
Customer Name: ROBINSON, REBECCA LYNN
Address 1: 1211 GRAYDON AVENUE
City, State, Zip: NORFOLK, VA 23507
This report does not acknowledge liability.
All reports Of missing items must be æported within 24 h0L_rs Of arrival.
Liability for the loss, delay or damage of checked baggage is limited in accordancewith the 4)plicable provisions of the American Airlines Contract of Carriage- The information is found at aa-com.
American Airlines assunes no liability for valuable/commercial items, including but not limited to: money, negotiable papers, securities, irreplaceable business documents, book manuscripts, books. publications, photographic or electronic equipment, musical instruments, jewery, silverware. precious metals, furs, antiques, artifacts, paintings and other works of art, lifesaving medications and samples in checked and unchecked luggage.
Unless excess valuation has been declared, liability for provable damages resulting from the loss. delay, or damage to baggage in
American Aitiines' custody is limited to $3500 for travel wholly between U.S. domestic points. For international travel, including domestic portions of international journeys. *ase refer to the Ameriæn Airlines Contract of Carriage.
https://live.nettracer.aero/american/reporting?print= 18&outputtype= 1 &language=en 10/12/2016
PASSENGER PROPERTY QUESTIONNAIRE
Mr. O First Middle Last Name Mrs. OGl—RZbez-cæ
Permanent Mailing Number Street
Address I I
Temporary Mailing Number Street
Postal Code 2 3
Email Address: b co
Your Complete Flight Itinerary
Have you, or any member ofyour household, had a previous baggage claim with AA or any other aiMine in the last 5 years? Yes No
If yes, list each airline, claimant name and dates (attach an additional page if necessary)
Information gathered on this form may be shared with other airlines, local, state and federal law enforcement agencies or private insurers.
Number of ticketed passengers traveling in your party: /
Number of passengers claiming missing baggage:
Purpose of trip
'r 6h I
Length of stay?
Were you charged for excess Yes No Did you declare and pay for excess value: Yes O No and/or overweight baggage: Value declared: $
Have you received your baggage and are you missing ntents only: Yes No If yes, how many bags are missing contents?
Was airline notified of loss immediately? Yes Non If yes, at what office? By telephone Cl In person
If airline was not notified within 4 hours, state the reason for the delay:
Where and when did you last see your baggage?
Has this loss been reported to another airline? Yes O No
If yes, please provide name of airline and city where reported.
Certification and Understanding
APPLICABLE IN USA ONLY. It is expressly understood and agreed by the claimant that the fumishing of this form and any assistance given by employees of American Airlines, Inc., are acts of courtesy and shall not constitute a waiver of any rights or an admission of liability by or on the part of American Airlines, Inc., its employees or agents. Any other information and/or documents relating to this statement which are required by American Airlines, Inc., will be fumished by claimant upon request and shall be considered part of this statement.
The United States Post Office has investigative jurisdiction under federal laws relating to sending false or fraudulent claims through the United States mail and any such claims received by American Airlines, Inc., are reported to the United States Postal Authorities. Loss of baggage in interstate shipment or of articles from such baggage come within the purview of federal statutes relating to thefts from interstate shipment and, are therefore, subject to investigation by the Federal Bureau of Investigation.
OP124 (Rev 08/25/2015) Complete Reverse Side
BAGGAGE AND CONTENT DESCRIPTION
NOTE: When more than one piece of baggage is lost, complete a separate baggage and content list for each missing bag.
Flight number(s) on aim
Airport checked from:
Airport checked to:
Baggage tag number(s):
Passenger ticket number(s): O O I —l q
Number of bags checked:
Number of bags received:
Baggage checked at: Curbside C] Ticket Counter Gate D Other O
Was baggage rechecked and newtags issued? Yes O No If yes, at what airport?
Was baggage available at Customs? Yes No O N/A If yes, at what city?
Give details if the original routing was changed after starting your trip:
Was your property packed in a box? Yes O No Was your property packed with an extemal cover? (example: golf bag) Yes O No
Is the name on the bag(s) different from the passenger? If so, what name?
Please list any initials, marks, tags, ribbons, cords, tape or other exterior markings on your bag(s):
Open/Close with Zipper
Cost of Bag
Gender = M: Male F: Female CH: Child l: Infant (under 2 yrs)
do hereby warrant the foregoing statement and those on the to be accurate, complete and true. I hereby ea claim against Ame • n Airlines, Inc., in the amountof$ fora loss occurring on 10/121 16
Claimant sign Date Claimant signature* Date
*Signatures are required for each pesenger claiming lost property. Parents may sign for their children under age 18.
• Your roundtrip flight consists of two one-way fares which are
Jacksonville to $307.10
subject to their own rules and restrictions. If one of your flights is changed or cancelled, it will not automatically change the other
flight. You may incur a penalty fee for each flight for additional
Norfolk to $353.60
• Remember to bring your itinerary and government-issued photo ID for airport check-in and security.
Total Price $660.70
All prices include taxes & fees and are quoted in US dollars. Your two oneway fares may be processed through multiple transactions.
Jacksonville (JAX) —+ Norfolk (ORF)
Oct 12, 2016 - Oct 12, 2016 , 1 one way ticket
American Airlines DMJCBX
Your reservation is booked and confirmed. There is no need to call us to reconfirm this reservation.
Traveler 1: Adult $307.10
Rebecca lynn No frequent flyer Ticket #
Taxes & Fees $41.05
Robinson details provided 0017869637516
All prices quoted in US dollars.
Seat assignments, special meals, frequent flyer point awards and special assistance requests should be confirmed directly with the
Oct 12, 2016 - Departure 1 stop Total travel time: 3 h 53 m
Additional Flight Services
• The airline may charge additional
1 h 29 m
fees for checked baggage or other
JAX 12:02pm CLT 1:31pm
Oct 12, 2016-Oct 16, 2016 | Itinerary # 7216708758069
American Airlines 5087 Operated by PSA AIRLINES AS
Economy I Coach (W) I Confirm seats with the airline *
Layover. 1 h 9 m l h15m
American Airlines 5395 Operated by PSA AIRLINES AS
Economy I Coach (W) I Confirm seats with the airline
Airline Rules & Regulations
We understand that sometimes plans change. We do not charge a cancel or change fee. When the airline charges such fees in accordance with its own policies, the cost will be passed on to you.
Tickets are nonrefundable, nontransferable and name changes are not allowed.
Please read the complete penalty rules for changes and cancellations applicable to this fare.
Please read important information regarding airline liability limitations.
Norfolk (ORF) —+ Jacksonville (JAX)
Oct 16, 2016 - Oct 16, 2016 , 1 one way ticket
Traveler 1: Adult $349.60
Taxes & Fees $45.41
Robinson details provided 0067869599980
Travelocity Booking $4.00
Oct 16, 2016 - Departure 1 stop Total travel time: 4 h 45 m
1 h 59 m
ORF 5:45pm ATL 7:44pm
Economy I Coach (Q) I Confirm seats with the airline
Layover. 1 h 31 m
On behalf of American Airlines, please accept our apologies for the missing article(s) from your baggage. For reimbursement consideration, it will be necessary to also complete a Passenger Property Questionnaire (PPQ) that is available from the website below:
Additionally, you can obtain this form at any American Airlines airport location from the Baggage Service Ofice. To facilitate our resolution ofyour claim, it is necessary that you complete and retum die PPQ to us promptly.
Please fax or mail the Passenger Property Quesfionnaire to the addressffax below with the appropriate documentation required. One of our Baggage Specialists will contact you via postal mail within 15 business days from receipt of
If you require assistance during this process. you may contact us at:
Customec Bagqaqe File Information:
File Number: ORFAA01322435 Date: 10/12/2016 20:37
City, state, Zip: NORFOLK. VA 23507
TMs report does not EÖiRy_
All repcyts Of missing Rems must be reFted 24 hat-rs Of
Liabifity for Ess, delay or dame* of is linited in accudawa with tho appliæblø provisions af the American Airlines Contract of Carriage. The informatbn is fourß at www_aa.com-
America-I Airtirzs assunes no liabilty for valuabWwmrnercial iterns, but nat limited to: money, negotiade papers, securities. Wepeeable business book martusaipts. books, photogr*ic or electronic equipment, musical instruments. jewery. silverware, preci01.s metals. ft.rs, artifacts. pairtmgs and other works of art, lifesaving medications and samples in and llÆgage.
Unless excess valuatim has been &dzed. fiabikty far darnages resuttirqfrom the loss. delay. or damage to baggage in
Ameriæn Aitmes' cNstody is limited to $3500 for travel wholly between U.S. domestic points. For internatiorzl travel, including domestic portims of inErnational jouneys. pese refer to the Ameriæn Airiirzs Contract of Cariage-
America-I Airtirzs assunes no liabilty for valuabWwmrnercial iterns, but nat limited to: money, negotiade papers, securities. Wepeeable business book martusaipts. books, photogr*ic or electronic equipment, musical instruments. jewery. silverware, preci01.s metals. ft.rs, artifacts. pairtmgs and other works of art, lif