Passenger Property Claim

Passenger Information
Full Flight Itinerary
    Flight #1
    Flight #2
    Flight #3

*Certification and Understanding APPLICABLE IN USA ONLY. It is expressly understood and agreed by the claimant that the furnishing of this form and any assistance given by employees of Boutique Air are acts of courtesy and shall not constitute a waiver of any rights or an admission of liability by or on the part of Boutique Air, its employees or agents. Any other information and/or documents relating to this statement which are required by Boutique Air will be furnished by claimant upon request and shall be considered part of this statement.

Bag details

Passenger Statement

I do hereby warrant the foregoing statement and those on accompanying forms to be accurate, complete and true. I hereby make a claim against Boutique Air for the following details: