This form is to be used only for claims relating to delayed or cancelled flights or in the case of misconnections. Please read the Bill of Rights which explains our obligations before you make a claim My Claim relates to (Tick √ applicable box) Cancelled Flight Delayed Flight Denied Boarding Schedule Change Other This form must be completed and submitted to Proflight via e-mail or in person to any Proflight office in Zambia with 21 days of the flight date. Please keep a copy of the completed form for your own records. First Name Family Name e-Mail Phone No: Address Line 1 Address Line 2 City Post Code Country Flight Details: Flight No From To Date Booking Identification: You must provide either your Booking Reference or Ticket Number: Booking Ref Ticket No. 6 characters Use the space below to provide us with details of your claim and an itemised list of expenses that you wish to Claim. You will also need to attach official receipts and any other documents that support your claim. Declaration by Passenger: I declare that the information provided below is correct and I acknowledge that Proflight’s liability is limited according to the Bill of Rights and Terms and Conditions of Carriage/Conditions of Carriage. Signature____________________________________________________Date____________________________________________ Comments: What to do next Option 1: Complete the form, keep a copy and then place the original in an envelope together with receipts and other documentation to support your claim. Return the form to a Proflight Zambia office within 21 days. Option 2: Print, complete and scan the form and then e-mail it as an attachment (with scanned copies of receipts, etc) to [email protected]