PROPERTY LOSS / DAMAGE CLAIM FORM

EIENDOMSVERLIES / -SKADE EISVORM

INSURED / VERSEKERDE

DETAILS OF LOSS / DAMAGE / BESONDERHEDE VAN VERLIES / SKADE

LOSS / DAMAGE ADDRESS / VERLIES / SKADE ADRES

CAUSE OF LOSS / DAMAGE / OORSAAK VAN VERLIES / SKADE

arrow&v

PREVIOUS LOSS / DAMAGE / VORIGE SKADE / VERLIES

arrow&v

POLICE / POLISIE

OTHER INTEREST / ANDER BELANG

OTHER INSURANCE / ANDER VERSEKERING

VALUE / WAARDE

Please upload the needed documentation to support your claim here.

Laai asseblief u nodige dokumentasie hier op om u eis te staaf.

Upload File
Upload supported file (Max 15MB)
TWK_Logo.png

T: (017) 824 1000 │ E: twk@twkagri.com │ 11 De Wet Street, PO Box 128, Piet Retief, 2380

© 2019 TWK AGRI (PTY) LTD | ALL RIGHTS RESERVED

PRIVACY POLICY

PROMOTION OF ACCESS TO INFORMATION ACT MANUAL

  • Facebook
  • Instagram
  • Twitter
  • LinkedIn
  • YouTube
button.png