创兴财产损失或损坏索赔表单（6页）.pdf-保险单证-保险资料库

创兴财产损失或损坏索赔表单（6页）.pdf

Please print clearly and return to Chong Hing
Insurance Company Limited L25, Tower Two,
Enterprise Square Five, 38 Wang Chiu Road,
Kowloon Bay, Kowloon.
Occupation 职业
Name of Claimant 索偿人姓名
I.D. Card No. 身份証号码
Policy
In
Name of
Address
(Please
Print
Clearly)
与投保人之关係
Relationship with Insured
Place of Employment 就职地点
and name of Co. 及公司名称
电话 (住宅) (办事处)
Phone : (Pvt.) (Bus.)
保单持有人的姓名及地址承受抵押者/银行
Mortgagee if any :
本人(等)现在报告以下财物所引致损失的原因是
I / We wish to report that loss / damage to
the property described below was caused by
发生地点
and occurred at
时间是
on or about
日期是
a.m./ p.m on the day of
请详述意外发生的情形
Description of how the loss/damage occurred (if known)