Lost or Damaged Property
Only complete this form if you have already had your insurance claim for the lost or damaged items refused
Surname *
Your answer
First name
Your answer
Student number *
Your answer
Bristol email *
Your answer
Residence *
Your answer
Date of insurance refusal *
We will ask to see a copy
MM
/
DD
/
YYYY
Approximate value of property lost or damaged *
Please note you will be required to provide receipts or other evidence
Your answer
Circumstances of loss or damage *
Your answer
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