Fillable Dear American Airlines Customer, Please accept our sincere (American Airlines)

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Dear American Airlines Customer, Please accept our sincere (American Airlines)

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Form OP124
Rev 04/13/2021
Dear American Airlines Customer,
Please accept our sincere apology for the mishandling of your property. We understand your concern and realize the inconvenience this
causes. Now that you have made your initial report, completing this form will allow us to intensify our tracing efforts with the goal of
locating and returning your property.
Complete all areas of this form and return it to us no later than 30 days from date of travel for Loss; and 30 days for Damage/Missing
Contents from the date of travel and/or the date the bag was received. Failure to return this completed form to us within the time frame
may result in the denial of your claim.
Check list:
Airline ticket receipts
Baggage claim checks
Original receipts are required for reimbursement of all delay expenses
Receipt(s) for excess value claimed
Receipt(s) for excess baggage charges paid
Receipt(s) for all items valued over $100.00
Receipt(s) for all items are required for Missing Content claims
Clear and legible government issued photo identification for each passenger making a claim
Damage claims: retain all damaged bags and/or contents until your claim has been resolved
Retain a copy of all documents submitted to the airline for your personal records
Please return completed form to us by submitting it online at aa.com/contactbags. If unable to submit the form electronically, mail it to the
address below:
American Airlines, Inc.
Central Baggage
4000 E Sky Harbor Blvd.
Phoenix, AZ 85034
Liability Limitations:
Liability for loss, delay, or damage to baggage will be limited as follows:
Domestic Travel (wholly within the United States) – $3,800 per ticketed passenger for
travel on or after April 13, 2021 Certain items are excluded from liability; see Contract of
Carriage at AmericanAirlines.com
International Travel (including domestic portions of international itineraries) is covered by the Montreal Convention – 1,288 SDRs
(Special Drawing Rights) per ticketed passenger
Thank you for your cooperation,
Your American Airlines Central Baggage Team
Form OP124
Rev 04/13/2021
Have you, or any member of your household, had a previous baggage claim with AA or any other airline in the last 5 years?
If yes, list each airline, claimant name and dates (attach an additional page if necessary)
Yes
No
Airline(s) Name(s)
Date(s)
Information gathered on this form may be shared with other airlines, local, state and federal law enforcement agencies or private insurers.
PASSENGER PROPERTY QUESTIONNAIRE
AAdvantage: File Reference Number:
Type of Claim: (check all that apply)
Lost Luggage
Missing Contents
Damaged Luggage and/or Contents
Delay Expenses
Mr. First Middle Last Name
Mrs.
Ms.
Phone Number
Mobile: Business:
Permanent Mailing Number Street Apt.
Address
Temporary Mailing Number Street Apt.
Address
City State
Zip Code
City State
Zip Code
Country
Postal Code
Country
Postal Code
Email Address: Employed by:
Occupation:
Your Complete Flight Itinerary
From To Airline Flight Number Travel Date
Number of ticketed passengers
traveling in your party:
Number of passengers
claiming missing baggage:
Purpose of trip? Length of stay?
Were you charged for excess
and/or overweight baggage:
Yes
No
Did you declare and pay for excess value: Yes
No
Value declared: $
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 and/or insurance company? Yes
No
If yes, please provide name of airline and city where reported and/or insurance company and phone number.
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
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 furnished by claimant
upon request and shall be considered part of this statement.
Th
e 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.
Complete Reverse Side
Form OP124
Rev 04/13/2021
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.
Baggage routing: Flight number(s) on claim check: Airport checked from: Airport checked to:
Baggage tag number(s): Passenger ticket number(s):
Number of bags checked: Number of bags received:
Baggage checked at: Curbside
Ticket Counter
Gate
Other
Was baggage rechecked and new tags issued? Yes
No
If yes, at what airport?
Was baggage available at Customs? Yes
No
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
No
Was your property packed with an external cover? (example: golf bag) Yes
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):
Bag Type Material Color(s) Brand
Bag
Dimensions
Open/Close
with Zipper
Wheels
Retractable
Handle
Purchase
Date
Cost of Bag
Hard
Soft
Yes
No
Yes
No
Yes
No
Gender = M: Male F: Female CH: Child I: Infant (under 2 yrs)
Qty Article/Item Size Gender
M,F,CH,I
Description Color Material Brand Label Store
Purchased
Purchase
Date
Original
Cost
1 Shoes 12 M White with blue stripes Leather Nike Sears Jan-13 $55.00
4 T-Shirts L M Undershirts White Cotton Hanes JCP Jan-13 $20.00
If
additional space is needed, please attach a separate page. Be sure to include a complete
description
and cost for each item along with receipts for all items valued over $100.00.
Please note: Receipt(s) for all items are required for Missing Content claims.
TOTAL: $
I do hereby warrant the foregoing statement and those on the accompanying forms to be accurate, complete and true. I hereby
make a claim against American Airlines, Inc., in the amount of $ for a loss occurring on .
Claimant signature Date Claimant signature* Date
*Signatures are required for each passenger claiming lost property. Parents may sign for their children under age 18.
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Dear American Airlines Customer, Please accept our sincere (American Airlines)

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Completed 20 April 2021

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