Claim Form

Fields marked with an * are mandatory

Contact Information:

*First Name

*Please enter the First Name.

*Last Name

*Please enter the Last Name.

Taj InnerCircle number (if applicable)

*Phone Number

*Please enter the Telephone Number.

*Email ID

*Please enter the Email Address.

*Preferred Mode oF Contact

Please select a valid Mode Of Contact

Booking Information:

*Booking ID

*Please enter the Booking ID. *Please enter a valid Booking ID.

*Hotel Name

*Please enter the Hotel Name.

*Arrival Date

*Please enter the Arrival Date.

*Departure Date

*Please enter the Departure Date.

Special Terms if any

*Booking Rate

*Please enter the Booking rate.

*Rooms

*Adults Per Room

Children

*Booking Currency

*Please select the Booking Currency.

Lower price Information:

*Lower Rate

*Please enter the Lower Rate.

*Currency

*Please select the Currency.

*Approx Date

*Please enter the Approximate Date.

(when lower rate was seen)

*Approx Time

*Please select the Approx Time.

(when lower rate was seen)

*Website on which lower rate was found

*Please enter the Website where lower rate was found.

*URL on which lower rate was promised:

*Please enter the URL where lower rate was found.

*Screenshot

*With price, dates of stay, room type, number of guests, etc.
Supported file types are PNG,GIF,JPEG,DOC,BMP,TIFF & PDF

*Please upload the screenshot of the lower rate.

Any additional information that will assist in claim processing

I accept the Terms & Conditions. *Please accept the Terms and Conditions.

*Please enter a Captcha