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	Individual Shipment Insurance Claim
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Record Shipment for Coverage

Support > Record Shipment for Coverage

Please use this form to report your cargo or freight shipment activity.

Please note: Do not use this form unless you have a AFI insurance Policy Number, If you do have an AFI discount insurance policy and you fill out this form, your shipment will not be insured!

*	Required Fields

A. Company Information
AFI Policy Number
Company Name:
Contact Person: *
Full Address: *
Phone: *
Fax:
Email
Save Company Info?:

B. Shipment Information
Shipment Date: *
Arrival Date: *
Reference Number: *