Cancellation Form Tui Belgium printable pdf download

Cancellation Form Tui Belgium

Callant Ltd.

Ref. Callant:

Kapellestraat 113, 8020 Oostkamp

Company number: BE 429.196.294

Telephone 050/33 52 49 - Fax 050/34.23.57

Name of travel agent :

E-mail: tui.claims@callant.be

Address :

Cancellation form TUI Belgium

To be submitted within 30 days to Callant NV, as soon as the travel agent is aware of the cancellation.

PO n° / Reservation number :

If there is a similar policy with another company:

With which company?

Policy n° :

Name of the insured :

Street :

N° :

Town :

Postal code :

Name of patient :

Street :

N° :

Town :

Postal code :

Relationship with the insured :

Destination :

Cost price of the trip :

Cancellation costs :

Number of persons cancelling :

Registration date :

__ / __ /____

Departure date :

__ / __ /____

Cancellation date :

__ / __ /____

What was the date on which the doctor advised you to cancel the trip?

__ / __ /____

Reason for cancellation: illness, accident, death*

Delete as appropriate

Other reason :

Name of beneficiary :

Account no. :

Bic :

Iban :

An incomplete declaration form may result in administrative delays.

To be submitted to Callant Ltd. within 30 days.

Your insurance company is Advent Limited Insurance PCC approved by MFSA under number C52.394.

The full text of the insurance conditions are available for inspection at:

Callant Ltd., Kapellestraat 113, 8020 Oostkamp. Tel. 050/33 52 49, fax 050/34.23.57 or with your travel agent.

Cancellation Form Tui Belgium

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