C-54ANNEXURE-‘B’
To,
Registrar,
Railway Claims Tribunal.
APPLICATION FOR REFERRING COMPENSATION CLAIMS FOR DAMAGE, SHORTAGE OR LOSS OF GOODS PARCELS.
Letter No.Dated :
To
The Chief Commercial Manager/Chief Claims Officer, ...…… Railway.
(Through Station Manager/Chief Goods Supervisor/Chief Parcel Clerk)
Dear Sir,
Sub: Claims for compensation: Invoice/Railway Receipt/Parcel way Bill Luggage Ticket No……………. of …………. From ……………. To………………..
Under section 106 and 192 to the Railway Act, 1989, I beg to prefer a claim on the ……………Railway, particulars of which are detailed below:
From ……………. (Station) to …………………….. Station via ……………………
Invoice and Railway Receipt/Parcel Way Bill Luggage Ticket No……………. dated……………. No. of packages and description of consignment booked as shown in the Receipt/Parcel Way Bill Luggage Ticket No……………………………………..........………….
Name of consignor …………………………………
Name of consignee ………………………………..
Date of Delivery …………………………………….
Details of shortage, damage or loss………………………………………………………………
Full particulars of the contents of the missing or damages packages/packages showing the value of each article packed therein (short or open delivery certificate, if any, should be enclosed…………………….
The amount claims and how it is arrived at (The original beejuck or other proof of the value of the goods together with a copy should be enclosed…………………………….
My/Our title to the claim: A letter of authority from the endorsed consignee, if necessary, and the Railway Receipt or Partial delivery certificate, original or certified copy, should be enclosed).
Other remarks, if any.Yours faithfully,
Encls:
Beejuck together with a copy
Letter of authority,(Full name & Address) subrogation etc.
Rly. Receipt of partial Delivery certificate or certified copy thereof.
Short of open delivery certificate.
ACKNOWKEDGEMENT
Received an application along with its annexure from Shri ………………………….. Consignee/endorsee in connection with above claim pertaining to RR No.……………………. Dated ……………. From ……….………
To………………………………
Station Manager/ Chief Goods Supervisor/
Chief Parcel Clerk…………… Station ………………. Railway
Note: 1.Claim application to be filed within six months from the date of booking of consignment. In case of delay/harassment, claimant can approach Add. G.M./G.M. concerned.