| APPLICATION FORM FOR CLAIM REFUND OF FREIGHT |
| OVERCHARGE OF GOODS / PARCELS |
IMPORTANT INFORMATION REGARDING PREFERRING CLAIM FOR REFUND OF FREIGHT
OVERCHARGES OF GOODS OR PARCELS CARRIED BY RAILWAY
In terms of Section 106(3) of the Railway Act , 1989, a person shall not be entitled to a refund of an overcharge in respect of goods carried by railway unless a notice therefore has been served by him or on his behalf to the Railway Administration to which the overcharge has been paid within 6 ( six ) months from the date of such payment or the date of such payment or the date of delivery of such goods at the destination station , whichever is later .
| To be filled in by Refund Office Received on ___________________________________________________________ Claim No ______________________________________________________________ Whether particulars adequate ? Yes No File No ________________________________________________________________ Year __________________________________________________________________
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| APPLICATION FOR PREFERRING CLAIMS FOR REFUND OF FREIGHT OVERCHARGE OF GOODS OR PARCELS CARRIED BY RAILWAYS |
Letter No …………………………………………… Date ………………………….
To
The Chief Commercial Manager
South Eastern Railway
14 Strand Road (9th Floor)
Kolkata – 7000001
Dear Sir ,
Sub : Claims for refund of freight overcharge of Goods or Parcel Invoice / Railway
Receipt / Parcel Way Bill No ………………………………….dtd ……………….
from …………………………………………………………..to……………………
Under Section 106(3) of the Railways Act ,1989 , I prefer claim for refund of freight overcharge , particulars of which are detailed below :-
1.Station from ……………………… Station to ……………………………… Station via …………………………
2.Invoice and Railway Receipt / Parcel Way Bill / Luggage Ticket No ………………………………………………
3.Description of consignment booked as shown in the Railway Receipt / Parcel Way Bill / LT …………
4.Name of the consignor ………………………………………………………………………………………………
5.Name of the consignee ………………………………………………………………………………………………
6.Name of the endorsed consignee ( if any ) ………………………………………………………………………..
7.Delivery Station ………………………………………………………………………..Delivery Date ……………...
8.a) Name of Claimant …………………………………………………………………………………………………
b) Postal Address with PIN Code …………………………………………………………………………………
9.Freight collected at station Rs ……………………………………………………………………………………
10.Amount claimed Rs ………………………………………………………………………………………………
Contd …… P/2
( 2)
11 Cause of Claim:
a.Excess collection of freight due to error in rate / weight
b.Excess collection of freight due to error in classification.
c. Excess collection of freight due to error in description.
d.Excess collection of freight due to error in routing of traffic.
e.Excess collection of freight through D/D.
f.Excess collection of punitive charges.
g.Twice collection of freights.
h.Non-granting of TIELS Rebate.
i.Excess collection of undercharges.
j.Excess collection of percentage charge
k.Excess collection of freight against sick wagon / wagons
l.Excess collection of freight for non-granting of Train Load facility
m.Excess collection of freight through e-payment.
n.Any other cause not mentioned above .
( Please mark “v and “X” for applicable and non- applicable items )
12 Money receipt No ………………………………………………………….Date……………………………………
13 Mode of Payment ……………………………………………………………………………………………………
14 Bank details with IFSC & MICR Code ……………………………………………………………………………
Yours Faithfully
Signature with
Full Name and Address of the Consignor
Recorded Consignee / endorsed Consignee / Claimant
Contd ….P/3
3
Enclo:
1.Copy of RR / PW Bill / Luggage Ticket .
2.Original valid Power of Attorney on stamped paper of the appropriate value ( if claim preferred by authorized
person / claim agent )
3.Original disclaimer certificate from the Consignor / Consignee / Endorsed Consignee as the case may be in
the form of Affidavit .
4.Original valid power of attorney and letters of Subrogation. If claims are preferred by the Insurance Company.
5.Original Money Receipt
6.Original other relevant documents, if any .
N.B.
1) Claim application shall be rejected due to non – submission of any documents as mentioned above .
