◆ SpookStack

mers MR. NAME MRS. MISS +e ADDRESS ATLANTA, SAEORG A RESIDENCE TELEPHONE (268 ¢Ode/numbe) y EMPLOYER/ (number) (street) ADDRESS f S RIBeceL. Su eee eq] PERMANENT (number) tareet NAO Leoal2A (city) (state) (zip) Resinence Cy IS10 Monroe WEN: (city) MILITARY/SCHOOL 315-q 198 eB: OCCUPATION BUSINESS {area code/number) TELEPHONE TEMPORARY (number) (street) ADDRESS TELEPHONE (airline) BA Yu (flight: number) Soe Ol FLIGHT ITINERARY “j- | NUMBER OF BAGS CHECKED 3 & WEIGHT OF BAGS CHECKED | | NUMBER OF BAGS RECEIVED | WEIGHT OF BAG(S) MISSING : BAGGAGE TAG NUMBER(S) OF BAG(S) MISSING WS COKTENTS OF MISSING BAGGAGE ARE: MALE FEMALE ___MIXEO__~_OTHER DESCRIPTION OF MISSING BAGGAGE (CHART ATTACHED) croup \AR ree cost® 75.00 coor _GRy size ——— 8x Gey MATERIAL BRAND MARKINGS (LABELS, ETC.) SOCIAL SECURITY NUMBER (city) (state) (date) Jano SAUG2 PASSPORT NUMBER LiByA GQ 28499 MILITARY SERIAL NUMBER - OURATION OF (days) STAY WAS EXCESS VALUE DECLARED? YES NO NO Attach copy of Ticket . oSo7 PASSENGER TickeT NuMBER (48.44 0S073 909 Attach copy of Ticket a“ BAGGAGE CHECKED AT Rome AIRPORT__city BAGGAGE LAST SEEN AT" RQ : BAGGAGE CHECKED TO (CITY SHOWN ON TAG) At LATA ON (AIRLINE/FLIGHT NUMBER) N YUM FINAL DESTINATION. WEAMTA WAS BAGGAGE RECHECKED AND NEW TAGS ISSUED? WAS AIRLINE NOTIFIED OF LOSS IMMEDIATELY? _V~ YES IF AIRLINE WAS NOT NOTIFIED, STATE REASON FOR DELAY ANY OTHER RELEVANT DETAILS NO. te vES7AC WHAT | time (VAS pateSQI O02 ay TetePHoNe on in PERSON? He PE Rson HAVE YOU HAD PREVIOUS BAGGAGE LOSSES YES _W_NO. HAS LOSS BEEN REPORTED TO ANY OTHER AIRLINE V__YES NO. IF YES, TO WHOM? Cerish Amann s ” IF YES, GIVE NAME OF AIRLINE AND DATE OF LOSS