Assertion of compensation claims according to Art. 7 Regulation (EC) No. 261/2004 Dear Sir/Madam, I hereby claim compensation according to Art. 7 of Regulation (EC) No. 261/2004 for: 1. Your Name / Street / Postal Code / City / Country _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2. Name of other Passengers (for example your Wife/Husband or Children) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ I claim compensation relating to flight number: _ _ _ _ _ _ _ which I booked from departure airport _ _ _ _ _ _ _ _ _ _ _ _ to arrival airport _ _ _ _ _ _ _ _ _ _ _ _ _ on booking date _ _ _ _ _ _ _. The flight was delayed for more than _ _ _ _ _ hours OR _ _ _ canceled OR _ _ _ took place without me. The problem was not based on exceptional circumstances or act of god. Due to the delay of _ _ _ _ _ hours and the flight distance of _ _ _ _ _ between the airports I have the right to be compensated by _ _ _ _ _ Euros for each passenger. I am writing this letter to request you to pay an amount of _ _ _ _ _ Euros / Passenger for each passenger, which comes to a total amount of € _ _ _ _ _ immediately, but not later than 21 days from the date of this letter. My bank account is Bank: _ _ _ _ _ _ _ _ _ _ _ _ _ _ IBAN: _ _ _ _ _ _ _ _ _ _ _ _ _ _ Swift/BIC: _ _ _ _ _ _ _ _ _ _ _ _ _ _ If I do not receive a response from you within the aforementioned deadline, I will seek immediate legal assistance. With best regards,