Property (Theft) Claim Form 财产（盗窃）索赔表格

财产盗窃索赔表格

请耐心地填写这个问卷，提供最详细和正确的资料，我们才可以完善地处理您的索赔
Property Theft Claim Form

Kindly complete this form and provide detailed and accurate information, so that we can handle your claim effectively
填写表格前，请先准备好以下资料 Please have the following ready before completing the form

事故细节 Info about the incident您的个人资料 Info about the insured汽车损毁照片 Photos of all damages

受保人的资料 Info about the insured
投保人／投保公司的英文姓名 Full name of owner / insured
您的联络号码 Your contact number
您的电邮地址 Your email address
example@example.com
您的ID/护照号码 Your ID / passport number
事件发生的实际地址 Physical address where incident happened

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
房屋的安全受到损害吗？Is the security of the house compromised?

是 Yes不是 No
请尽量减少更多损失，否則索賠會受影响 Please reduce further losses as much as possible to avoid issues with the claim

我理解 I acknowledge

财产损失，被盗或损坏的声明 Statement of property loss, theft or damage

	属性说明 Description of property	数量 Quantity	购买日期 Date bought	购买于 Purchased from	索偿金额 Amount claimed
1
2
3
4
5
6
7
8
9
10

照片 Photos
损毁照片（可以选择多个档案） Photo of damages (multiple selection allowed)

上载多个档案 Upload multiple files

Cancelof
其他相关资料（例如维修报价） Other relevant info (e.g. repair quote)

上载多个档案 Upload multiple files

Cancelof

宣言和签名 Declaration & signature

我在此确认以上资料正确无误，如果还有其他对保障有影响的额外资料，我会尽快提供给我的保险顾问和公司。I hereby declare the foregoing particular to be true in every aspect. If there are additional information that may have a material impact on the policy, I will inform my advisor and insurer as soon as possible
受保人的签名 Signature by the insured

Clear
Should be Empty:

财产盗窃索赔表格