Lonza SWAT Claims Form
Please fill up the form in full with all required details. Claims submitted after the 14th day of incident will be rejected and not reimbursed. Please also attach relevant softcopy of the complete and original receipt or transaction details (e.g. for Grab) which includes date and time, evidence to take alternative transport (boarding pass and time stamp), else the claims will be rejected. Please ensure that payment information is accurate, else claims might not be received successfully. Thank you very much and we apologise for the inconvenience caused.
Full Name
*
Phone Number (SG numbers only)
*
Please enter a valid phone number.
Amount Claimable ($)
*
type in values only
Amount Claimable ($)
*
type in values only
Employee ID
*
Email
*
example@example.com
Date of incident
*
-
Month
-
Day
Year
Date
Bus Display Number
*
Bus-stop Location
*
Reason
*
Bus no show
Bus is more than 10 mins late
Bus left pick up point early
Bus breakdown
Received in-app notification to take alternative transport to office
Other
Taxi Receipt + Boarding Pass/in-app notification (Clear pictures/screenshot required. *Note that unclear receipts may result in a delay of claims processing)
*
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PayNow Transfer Details - Phone Number
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