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Get Air Canada Interim Expenses Claim Form

Cked Bagage?________ Amount paid ________________________ (Attach receipt) 5. Did you declare “excess valuation” and purchase additional coverage?_____ Value declared_______________ Amount paid __________________________(Attach receipt) 6. Was there a name, address or any other identification on the bag(s)? (i.e. tags, stickers, ribbons) _______________________________________________________________________________________ 7. Was the loss reported? ______________Time ______________Date ____.

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