Hamer van Hussen Groenendijk | Marine Cargo Surveyors

Your name*

Phone number*

E-mail address*

Company name*

City

Country

Type of claim

Transport Storage Other

Transport type

Ship Truck Train Air-carrier

Containerised transport?

Yes No

Container nr

Has vessel been chartered via your company or and affiliate of your company?

Yes No Unknown

Nature of damage/short damage description
in case of more types of damages, take the most important one

Any additional remarks about damage description?

Yes No

Please describe the damage

Indication of cause of the damage

Goods/commodity

Insured quantity

Value of the goods

On which Incoterms were goods purchased

Which company was the seller of the cargo

Do you have a certificate (or copy) of insurance document?

Yes No Unknown

Date of issue (or upload document)

Date of loss or discovery of loss

Place where damage was discovered

(Rough) Estimation of loss

Who is to be contacted for this matter (+phone)?

Yes No Unknown

Name and phone surveyor (if available)

If available, please upload copies of:

Upload of document(s) and/or picture(s), max 20 MB

Confirm Humanity

First Notice of Loss Form