Aviation Application Form

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Aviation Adjudication Online Form

What is this application for?

This application form is for passengers to bring a claim against an airline or airport if they have not been able to resolve the complaint directly with them.

The application form will ask you for the details needed to understand what you would like the airline to do and to help an adjudicator decide your dispute.

What do I need to do?
- Read the Guidance for Passengers fact sheet. If you are unsure of how to answer a question please contact CEDR for guidance
- Fill in the application form giving as much information as you can. If you are claiming for things that have been lost or damaged remember to include any receipts you have
- It may take you some time to go through the application form and to get all your facts together, but having all the information will help CEDR assess your case fairly
You must have already complained to the airline before you can make an application to CEDR.

You can only make an application if you have not been able to settle your dispute with the airline or airport directly after eight weeks has elapsed since you first complained or if the airline/airport has provided you with its final response in relation to the dispute, otherwise known as a final position or deadlock letter.

Please let us know if you have any practical needs where we could help – for example with information in another format (e.g. larger print, Braille etc.) or in another language.

PDF Application Form Available

If you require a printable version of the application form, to post to us, please click here. We can also send you a paper version, please email aviation@cedr.com to arrange this.

If you would like to post your application in, please download the PDF application form above.

You can send applications to:
CEDR Services Ltd
100 St. Paul's Churchyard
London
EC4M 8BU
We can only process complaints that have first been raised with the airline or airport. Have you raised your complaint with the airline or airport directly?*

YesNo

Aviation Adjudication Scheme

Application Form
1. About you

Please give us your details.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

TownCounty

Post Code
Email*
example@example.com
Telephone

Area CodePhone Number
2. Representation
If someone is complaining on your behalf, please complete and sign the Representative Authority Form at section 9.

You will need to sign the Representative Authority Form and provide proof of your identities. Proof of your identity must clearly display each customer's name and signature, e.g passport or driving licence.

3. Flight Details

Please tell us about the flight this claim relates to or name the airport the complaint is about
Airline or Airport*
Number of additional passengers on the booking (if applicable)
Names of additional passengers on the booking (if applicable)
Booking number*
Flight number*
Departure airport*
What time was the flight scheduled to depart?*
What time was the aircraft scheduled to arrive?*
What time did the aircraft land at the destination (if known)
Date of departure*

DayMonthYear
Destination airport*

4. Complaint History
On what date did you complain to the airline or airport?*

DayMonthYear
On what date did they send you a final position letter?*

DayMonthYear
Please provide the complaint reference number given by the airline or airport?*
4. Compensation Claimed
Please provide details of the compensation that you would like the airline or airport to provide by itemising your claim in the table provided.
You should provide details of each item you wish to claim for, why, and how much. Once submitted, the amount claimed cannot be changed.*
Please ensure that the total amount you are claiming is completed in the box below.*
6. Evidence
Please upload any documents that support your claim such as:
- Booking forms
- Photographs
- Correspondence with the airline
- Receipts
- Receipts
- Flight schedules
- Media (audio/video)
- Other evidence you consider relevant (please specify below)
Please upload any supporting evidence

Limit: 10 files
Cancelof
7. Other Information
Please provide details of any other issues that you believe are relevant to your claim

8. Payment Information
If your claim is 100% unsuccessful you will be asked to pay a contribution of £25 towards the cost of the adjudication. Please note that this is a cost per case and not per passenger. You will not be charged anything if your claim is successful and you will receive 100% of the compensation awarded by the adjudicator.
9. Representative Authority Form
Please tick all boxes in this section.

Please note that you and all other passengers on the booking must sign this form below and provide proof of their identities. This proof of identity must clearly display the customer’s name and signature, ie. passport / driving license.I/We hereby give authority for the person named below to represent me/us in my application for CEDR adjudication.I/We understand and accept that the adjudication will be conducted in accordance with CEDR’s Scheme Rules.I/We understand that it is my/our responsibility to read the available guidance, which can be found on CEDR’s website or by contacting the CEDR office, and/or ensure that the representative stated below has done so in order to understand the adjudication process.I/We understand that if a settlement is agreed or if directed by the adjudicator, the airline/airport will provide any payment of redress directly to the passenger and not a representative. Each customer will need to provide their own bank details so that they can be paid directly to a bank account in their name only.I/We acknowledge that each passenger on the booking must sign below and provide a copy of an approved form of identification that displays the passenger’s signature (e.g. driving licence, passport).
9. Representation Details
Name

First NameLast Name
Organisation
Address

Street Address

Street Address Line 2

TownCounty

Post Code
Email
example@example.com
Telephone

Area CodePhone Number
Signed by the passenger

If you have passengers under the booking for this claim, please have them sign below. If you do not have other names on your booking, please go to question 10.
Name - Passenger 1

First NameLast Name
Date

DayMonthYear
Signature

Clear
Name - Passenger 2

First NameLast Name
Date

DayMonthYear
Signature

Clear
Name - Passenger 3

First NameLast Name
Date

DayMonthYear
Signature

Clear
Name - Passenger 4

First NameLast Name
Date

DayMonthYear
Signature

Clear

10. Declaration
Data Protection Act

The Data Protection Act allows CEDR subscribing airlines to provide information and/ or documents about you to CEDR Scheme administrators and the adjudicator with your consent. By completing this form you are giving your consent.
Please tick all boxes in this section.*

I accept that the adjudication will be conducted in accordance with the Scheme Rules. I understand that the Scheme Rules can be found on the CEDR website or that I can request a copy of these Rules by making contact with the CEDR team.I accept that it is my responsibility to understand how the Scheme works. I understand that guidance and information on how the Scheme works can be found on the CEDR website and/or making contact with the CEDR team.I understand that it is my responsibility to read the available information in order to understand the adjudication process and that I can contact CEDR for guidance on the process if necessary.I have not previously referred this dispute to a court of law.I understand that the airline or airport will provide information about me and my claim to CEDR.I agree to pay CEDR the sum of £25 if my application is 100% unsuccessful.
Signature*

Clear
Name*

First NameLast Name
Date*

DayMonthYear
11. Reasonable Adjustments
If you consider additional support is needed to access our services, please advise us of this below. We will consider your request in line with our Reasonable Adjustments Policy.
Please verify that you are human*
Should be Empty:

Aviation Adjudication Online Form

What is this application for?

What do I need to do?

You must have already complained to the airline before you can make an application to CEDR.

PDF Application Form Available

Aviation Adjudication Scheme

1. About you

2. Representation

3. Flight Details

4. Complaint History

4. Compensation Claimed

6. Evidence

7. Other Information

8. Payment Information

9. Representative Authority Form

9. Representation Details

Signed by the passenger

10. Declaration

Data Protection Act

11. Reasonable Adjustments