Submit a Claim Name* First Last Email* Phone*Hotel Name*Upload Hotel Reservation*(jpg, png, pdf, docx)Arrival Date* Date Format: MM slash DD slash YYYY Departure Date* Date Format: MM slash DD slash YYYY Cancel Date* Date Format: MM slash DD slash YYYY Select Cancellation Reason*WeatherMeeting CancelledFamily EmergencyRe-booked at Same HotelPlans ChangedReservation no Longer NeededOther ReasonOther ReasonCancel Fee Amount*Last four digits of credit card used to hold reservation*Has the hotel charged your card yet?*YesNoHave you contacted the hotel yet?*YesNoSubmitting your claim is risk free!Your credit card will only be charged if we are successful in winning your fee back from the hotel. The charge will be 35% of what the hotel refunded.Credit Card American ExpressDiscoverMasterCardVisa Card Number Expiration Date Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Security Code Cardholder Name Quick Card AuthorizationTotal $0.00