Customer Claim Form
Customer Name:* Company Name: Phone No:* Email ID: Date:* Delivery Branch:* ADONI AGRA AHMEDABAD AHMEDNAGAR AKLUJ (SOLAPUR) ALLAHABAD ALLEPPEY ALWAYE AMBATTUR AMBERNATH AMRITSAR ANAKAPALLI ANANTHAPUR ANDHERI ANKENPALLY ANKLESHWER ARAKONAM ASANSOL AURANGABAD AUTONAGAR(VIJ) AZADPUR BADDI BADLI BALANAGAR BALASORE BALOTRA BANARAS BANGALORE BANGALOREHUB BARAMATHI BARMER BARODA BEGUMBAZAR BEHRAMPUR BELGAUM BELLARY BHADRACHALAM BHAGALPUR BHAGWANPUR BHATINDA BHAV NAGAR BHAWANA BHAYENDER BHILWARA BHIMAVARAM BHIWADI BHIWANDI BHOPAL BHOSARI BHUBANESHWAR BIKANER BILASPUR BOLARAM BOMMASANDRA BOWENPALLY BRODWAY BURHANPUR CALICUT CHAKAN CHANDIGARH CHANDIGARHROAD CHATTABAZAR CHEEMACHOWK CHENNAI CHENNAI HUB CHERLAPALLY CHIRALA CHITTOOR CHURU COCHIN COCHIN HUB COIMBATORE CPD DAPODI DAYABASTI DEHRADUN DEWANDHOWDI DEWAS DIBRUGARH DISPUTEOS DOMBIVLI EACHANARI ELURU ERNAKULAM ERODE ERODE(SRINIVASA) FARIDABAD FINANCE FINHO GACHIBOWLI GANDHI BAUG GANDHI NAGAR (KOLHAP GANDHIDHAM GANDHINAGAR GANDHIPURAM GEDDALAHALLI GHAZIABAD GOA GORAKPUR GOREGAON GUINDY GUNTUR GURGAON GURGAON(HHG) GURGAONHUB GUWAHATI GWALIOR HANDASWAMI HARIDWAR HEADOFFICE HINDUPUR HISSAR HO HOAUDIT HOBLH HOLOCAL HOSUR HR HUBLI HYDERABAD ICHALKARANJI ICHAPURAM INDORE INDORE HUB INTERNATIONAL JABALPUR JAIPUR JAIPUR VKIA JALANDHAR JALGAON JAMALPUR JAMMU JAMNAGAR JAMSHEDPUR JAYSINGPUR JEEDIMETLA JHARSUGUDA JODHPUR KAILASH NAGAR KAKINADA KALASI PALYAM KAMALA MARKET KANKROLI KANNUR KANPUR KAPOLI KAPWAD KARAD KAROLBAGH KATEDAN KATIAWALA TANK KAVALI KHAWASPUR KOLHAPUR KOLKATTA KOLKATTA HUB KOLLAM KOMPALLY KORBA KOTTAYAM KOYAMBEDU KRPURAM KUNDLI KUPWAD MIDC KURNOOL L.B.NAGAR LALRU LONI LUCKNOW LUDHIANA MADANAPALLY MADHAV NAGAR -SANGLI MADURAI MADURAVOYAL MAGADI ROAD MANGALORE MANGALPURI MARKET YARD (PUNE) MAYAPURI MEDCHAL MEERUT MEERUT(HHG) METAGALLY MIRAJ MOULALI MUMBAI MUNDKA MUZAFFAR NAGAR MYSORE MYSOREROAD NACHARAM NAD X ROAD NAGARJUNASAGAR NAGAUR NAGPUR NAJAFGARH NALAGARH NANDEDGAON NANDHYAL NANGLOI NARAINA NARELA NAROL NARSINGPUR NARSIPATNAM NASIK NAWA CITY NEELMANGALA NELLORE NEW COTTON MARKET NEWALIPUR NEWDELHI NIGDI NOIDA NRJAKHIRA OKHLA ONGOLE OSDCLOSE OSDDETAINED PALAKKAD PALI PALLAVARAM PANDARIPUR PANIPAT PATANCHERU PATELCHOWK PATNA PATPARGUNJ PEENYA PERUNGUDI PERUNKUDI POLO GROUND (INDORE) PONDICHERRY POONAMALLE PORTBLAIR PUNE PUNE HUB PURNA PURSUNGI RABALE RAIPUR RAJAHMUNDRY RAJAMUNDRY RAJKOT RAMAROAD RAMNAGAR RANCHI RAXAUL RENUKOT ROHINI ROHTAK ROURKELA RUDRAPUR SADARBAZAR SADASIVPET SAKINAKA SALEM SAMEPUR SANGLI SANJAYGANDHI NAGAR SANJAYNAGAR SATARA SATIVALI SECUNDERABAD SHAHDARA SHAPURNAGAR SILIGURI SOLAN SOLAPUR SRIKAKULAM SRIPERUMBUDUR SUFIYACHOWK SURAT TADIPATRI TALEGAON TALOJA TANUKU TARAPUR TATHAWADE THADEPALLIGUDEM THANE THIRUVOTTIYUR TIRUPATHI TIRUPUR TIRUVALLUR TRANSPORTNAGAR TRICHUR TRICHY TRIPUR TRIVANDRUM U.P.BORDER U.P.BORDERHUB UDAIPUR UDAYPUR UDGIR VAPI VARANASI VASAI VASAIEast VASAIROAD VASHI VATWA VELACHERRY VEPERY VIJAYANAGARAM VIJAYAWADA VISAKHAPATNAM VISHWAS NAGAR WADI WAGHOLI WELLINGTON ZAKIRA ZIRAKPUR GC No:* GC Date:* Gen.DairyNumber:
Booking Branch: Delivery Branch: Delivery Date: Booking Amt: FOV:* Yes No No.of Pkgs
SNO ItemNo Asper PkgList Damaged Article Shortage Article Declared Amt as Pkg List * Demand Amount Remarks Actions         Total:
Claim Details: Upload Documents: (Kindly upload max 20 pics only) SNO Document Type Document Remarks Actions LR Packing List Customer Letter Damage Pics
DataEntry Person: DataEntry Date: