AIR PASSENGE RIGHTS CE DREJIAr AJRORE TE PASAGJEREW) EU COMPLAINT FORM I ANKMIMII)

Transcription

1 ":-=*::,!f..'=,,,...,;"' ]{ubridi i Agiici@it cieil AIR PASSENGE RIGHTS CE DREJIAr AJRORE TE PASAGJEREW) EU COMPLAINT FORM I ANKMIMII) THIS FORM CAN BE USED TO LODGE A COIUPLAINIWITH AN AIRLINE AND/OR A NATIONAL ENFORCEI\,,IENT BODY, KY FORMULAR MUND TE PERDOREI PER TE PAMQIrUR NJE ANKESE PER NJE KOMPAN' AJRORE DHHOSE NJE ORGAN KOMBE AR ZBA UES. Passengerights in case of denied boarding, downgrading, cancellation or long delay of their flight under Regulation (EC) 261/200and Ministry Qrder Nr. '1, on February 26, 2013 Te drejtat e pasagjereve ne rast mospranimi ne.bord, ulje e kategorise se sherbimit, anullimi ose pritje e gjate e fluturimit sipas Rregullores 261/2004 dhe Udhezimit Nr. 1, date 26 shkutl 2013 /NSIRUCI'O'VS (UDHEZ'ME) 1) Passengers who believe they have a valid aomplaint against an airlire regarding denied boarding, downgrading, cancellation or long delay to a given flight should fist submit such a complaint to the airline operating the flight concerned. This form may be used for that purpose. Please keep a copy of lhis form for your records. (Pasagjeret te ci,et besojne se kane nje ankese te v/ fshme kunder nje kompanie airore lidhur me mospranimin ne bord, uljen e kategorise se sherbimit, anullimin ose p tjen e gjate te nje fluturimi te dhene, duhet se pai te paraqesin nje ankese ne kompanine ajrore qe opercn flulurimin ne iale- Ky formular mund te perdoret per kete qellim- Ju lutemi mbani nje kopje te ketij formulafi per te dhenat tuaja.) 2) Should the airline fail to provide you with a reply within 6 weeks of receipt or, if you are not satisfied with their reply, this form (a copy of the original form sent to the airline may be used) should be sent to the national enforcement body in the Member State where the incident took place. (Nese kompania ajrore deshton per te te siguruar nje pergjigje brenda 6 javeve nga manja e ankeses, ose rese ju nuk jeni te kenaqur me petgjigjen e tyre, ky formular (mund te perdoret nje kopje e formulait oroinal derguar linjes ajrcre) duhet te dergohel ne organet kombetare te zbatimit ne Slrtetin Anetar ku ka ndodhu incidenti.) 3) ff the incident took place at an aieort of departure outside the EU, you may contact the national enforcement body in the Member State of flight destination. (Nese incidenti ka ndodhur ne nje aeropoft nisjeje jashte BE, ju mund te kontakoni organin kombetar te zbatimit ne Shtetin Anetar te destinacionit te fluturimit,t 4) This complaint form is to be used only for cases concemed with denied boarding incident, downgrading, cancellation, or long delay of a flight. (Ky formutar ankimimi duhet te perdoret vetem per rastet ne qab si incidentet ne rast mospranimi ne bord, ulje e kategorise se sherbimit, anullimi ose pritje e gjate e fluturimil) 5) For any other complaint types such as baggage claims, flight schedule changes made more than 14 days in advance of your travel date ot tbkelng rssues, these too should be subnitted tirst to lhe airline concerned. Should you not reeeive a reply, or if you arc not satisfied with the reply, the European Consumer Centrcs in any Member State of the EU can be nntacted fot fudher advice. (Per ojet e tjem te ankimimit si kerkesat per bagazhet, ndryshimet ne onrin e fluturimit E bera ne me shume se 14 dita ne avance te dates se udhetimit tuaj, ose ceshtjet e biletave, duhet gjithashtu t'i dorczohen se pari kompanise ajrore ne tjale. Nese nuk merrni nk pergjigje, ose nuk jeni te kenaqu me pergjigjen, Qendra Eurcpiane e Konsumatorit ne cdo s'lfel anetar te BE mund te kontaktohet per keshilla te metejshme.) 6) Please li in the form in block cadital letters. Ju lulemi Dtotesoni fomularin me shkronia te medha

2 Complalnt submitled by: Anhesa paraqitd nga: Name (Emri): Address (Adrcsa): CostcoOrj, city fxodiposta, qyteti): Sumame (Mbiemr'): Country (Sl'feft:

3 Complaint concerning the following flight: Ankesa lidhur me fluturimin e meposhtem: 1) Atline (Kompanta ajrcre): 2) Ticket number /wri biletes): 3) Eooking reference (Referenca e prenofi mn:. 4) Airport of departurc (Aeroporti i nisjes): 5)Connecting airport (if any) (Aeroporti,idhes, nese ka te titte): 6) Date of your flight (Data e tluturimi tu4): 7) Scheduled time of departure (Ora e phn ifikuar e n isjes) : 8) Scheduled time ofarrjval (On e ptanilikuar e mberitjes): 9) Airport(s) where the incident occurred (Aeropoitilet ku ka ndodhur inciclenti): Flight number (rlrumn i flutuimq: Airport of anival (Aeroporti i mberritjes): Actual time of departurei (On aktuate e nisjes) Actualtime of anival: (On aktuale e mberrues) Passenger details for flight detailed above: Detaiet e pasagjereve per fluturimet e detajuera te mesipeme: Name of Passenger (Emri i pasagjerit) Please indicate if Adult, Child or Infant (less than 2 years) (Ju lutemi perca4onite rritur, Femije apo I mitur (me i vogel se 2 vjec)) Please indicate if special assistance was required (Ju lutemi perca$oni nese n/b asrslence e vecante ka qene e nevojshme) t1r t\ t- Please carefully read these definitions, and indicate wlth a cross [xi that which applies to this complaint. Ju lutemi lexoni me kujdes keto perkufizime, dhe vendosni nje kryq [n, aty ku ka vend per ant(ese, Z) 'Long delay' means when a flight does not depart until after the scheduled departure time by: 'Vonese e gjate' do te thote kur nje fluturim nuk do te n sef derl pas kohes se planifikuar te nisjes prej: 8) a. two or more hours, for flights of up to 1500km; (dy ose me shume oresh, per fluturimet e nje largesie prej 1500 kn): b. three or more hours for intra-eu flights of 1,500 km and longer, or for other flights between'1501 and 3000 km; (tre ose me shume oresh per fluturimet brenda BE me nje largesi 1500 km ose me shume, ose per fluturime te tjera midis 1501 dhe 3000 km); c. four or more hours, for all other flights. (kater ose me shume oresh, per te gjitha fluturimet e tjera). 'Cancellation' means the non-operation of a flight that was previously planned. 'Anullim' do te thote mos-realizimi i nje fluturimi qe ishte planifikuar me pare. 9) 'Denied boarding'means a refusal by the airline to carry a passengers on a flight on which they hold a confirmed reservation and where have presented themselves for check-in and at the boarding gate not later than the time advised by the airline, tour operator or travel agent (if

4 no time was indicated, not later than 45 minutes before the scheduled departure time) This does not include situations where the airline or its agent has reasonable grounds t0 de-ny pasiengets OoarOing, such as reasons of health, saiety, and/or security' or in cases of inadequate travel documentation 'Mtosoianim ne bord' do te thote nie refuzim nga nie kompani ajrore per te transponuar nle ii"{g!.r'ii rj" nriurim ku ai ka iryer nie rezenim te Ronfirmuar.dhe eshte paraqitur per 'ii"ili-i, nu po,t, e caktuar io me vone se ora e keshilluar nga kompania airore' opgralon.l ianitin oie ugi"ntiudhetimit (nese nuk eshte treguar asnk ore'.io me vone se 45 minuta piiriiri or"" t{punifikuar te nisies) Ketu nuk peishihen sitult!! nie linje airore ose 'aobnti lu i linies. kane baza te arsyeshme perte mohuar nisien e pasagpreve, s arsye,t"iit"t"!ii, dhe ose sigurie, ose ne rastet e dokumentacionit te pamiaftueshem te udhetimit. "ut"ty 10) 'Downgrading' means the passenger involuntarily travelled in a class of service lower than the class 6f service for which they had a confirmed reservation' iiil" i x"l"gori"" "e sherbimit, do te thote qe pasagjeri ne meqyre te pavullnetshme udheton iiii xtii; ^" t" u/et sherbimi se sa ktasa e sherbimit ku ka ktyer rezenimin e konfirmuar. Did the passenger(s) hold a confirmed reservation on the flight concerned? Aiat xin" moiitui pasagjeri/et nie rezenim te konfirmuar te fluturimit ne fiale? tr NO (Jo) Did the passenger(s) presenthemselves at the check-in desk at the latest at the time irj""t"i ov tli"iiline (or if no time was indicated: not later than 45 minutes before the published 'i departu.e time of the flight)? pirriqit"ii pu"gleri/et te* spoiei i kontroltite biletave ne minuten e f undit te dhene nga kompania airore (ose nese nuxka kohe te dhene: h me shume se 45 minuta perpara ores se ;ubtikuar te nisies se fluturimil)? tr YES (PO) tr NO (JO)

5 Did the passenger(s) present themselves at the boardingate before the time indicated on the boarding card? A paraqitet/n pasagjeri/et ne potten e nisies perpara ores se shenuar ne boarding card? tr YES (PO) tr NO (JO) Did the airline provide the passenger(s) with information on their rights? A u siguron kompani ajrore pasagieriueve intomacion per te dreitat e tyre? I hereby decla.e that all of the infonnation provided in this.fotm is true and accurate in all respects and for all the passengens concemed. IJne deklarcj se le gjitha informacionel e dhena ne kete fonnnlat iane te veftels dhe le sakta ne te gjitha ospehtet dhe per te giithe pasagiercl ne fiale. Signature(s) of all adult passengef: Firmo/t e te gjithe posqgiercve adult:

6 IN GASE YOUR FLIGHT WAS DELAYED: NE RAST SE FLUTURIMI JUAJ VONOHET: Did you receive assistance from the airline or its agent during your long delay? A keni marre asistence nga kompania ajrore ose agjenti i saj gjate pritjes se gjate? E YES (PO) What kind of assistance has been provided to you? Cfare lloji asistence kane siguruar per ju? E i/eals ( Yakte.) E Refreshments (Pie freskuese) E Place of accommodalion (hotel or other) (in case the delay resulted in an overnight stay) (Akomodim(hotel ose te tjera) (ne rast se vonesa rezulton me nie nate qendrim)) E Transfer between airport and place of accommpdation (in case the delay resulted in an overnight stay) (Transferim nga aeroporti ne vendin e akomodimit (ne rast se vonesa rezulton me nje nate qendim)) E Communication facilities (telephone calls, fax or messages) (Lehtesira komunikimi (thirie telefonike, faks ose mesazhe i) E Other services (please specify): (Sherbime te tjera (ju lutemi specifikoni)):... lf the delay of your flight was of 3 ttours of more affer the arrival time originally scheduled' did you receive any tinancial compensation? Nese voresa e t/uturimit tuaj ishte tre ore pas ores origjinale te planifikuar te anities, a moret kompensim financiar? Amount:... Shuma: ALL... lf the delay of your flight was longer than 5 hours: Nese vonesa e fluturimit tuai ishte me e gjate se 5 ore: Did your flight still serve a purpose? A sherben ende tluturimiiuai per nk qellim? tr YES (PO) tr NO (JO) In case your answer to the previous question is 'no' and in case your journey had already commenced: were you offered a seat on a flight back to your first point of departure? Ne rastin kur pergjigja e pyeties se mesiperm eshte "JO" dhe ne rast se udhetimi juaj nis. a te eshte ofruar nje vend ne nie fluturim mbrapsht ne piken e pare te nisjes? tr YES (PO) In case you decided not to continue your journey, were you offered a refund? Ale rasf se lu vendosni te mos vazhdoni udhetimin tuai, a iu eshte otruar nie shperblim? n for the whole ticket pice (per cmimin e Plote te biletes) E for the non-used iight coupons (per segmentin e udhetimit te pakrye) I I I I

7 IN CASE YOUR FLIGHT WAS CANCELLED BY THE AIRLINE: NE MST SE FLUTUNMI JUAJ ESHTE ANULLUAR NGA LINJA AJRORE: Were you informed about the fact that your fllght was cancelled A jeni informuar per faktin se fluturimi eshte anulluar El after your arrival at the airport? pas mberritjes ne aeropott? E before you arrived at the airport? para mberritjes ne aeropod? E less than 1 week before the planned departure time of your flight? me pak se 1 jave perpan ores se planifikuar te nisjes se fluturimit tuaj? E between 7 days and 2 weeks before the planned departure time of your flrght? midis 7 ditesh dhe 2 javesh perpara ores se planifikuar fe nis./es se fluturimit tuaj? El more than 2 weeks before the original schedule departure date of your ftight? me shume se 2 jave perpara dates origjinale te planifikuar te nisjes se fluturimit tuaj? Were you offered an alternalive flight? A ju eshte ofruar nje flutuim alternativ? E YES (Po) Were you informed about the reason why your flight was cancelled? A jeni informuar per arsyen se pse fluturimijuaj eshte anulluar? E YES (Po) What was the reason given to you? Cila ishte arsyeja e dhene? El No (Jo) Did you receive assistance from the airline or its agent at the airport? A keni marre as,slerce nga linja ajrore ose agjentet e saj ne aeroport? EI YES (PO) What kind of assistance has been orovided to vou? Cfare lloj asislence te eshte dhene? E Meals fyakfe) E] Refteshments (pije freskuese) E Place of accommodation (hotel or other) (in case the cancellation resulted in an overnight stay) (Akomodim(hotet ose te tjera) (ne rast se anullimi rezulton me nje nate qendrim)) E Transfer between airport and place of accommodation (in case the cancellation resulted in an overnight stay) (Transferim nga aeropofti ne vendin e akomodimit (ne rast se anullimi rezulton me nje nate qendrin)) E Communication facilities (telephone calls, fax or messages) Lehtesira komunikimi (thir1e befonike, faks ose mesazhe i) E Other services (please specify): Sherbime te tjera (ju lutem specifikoni):..._... O No (Jo)

8 I Did you receive any financial compensation for this cancellation? A keni mane ndonie kompensim ftnanciar per kete anullim? tr YEs (Po) Amount:..... Shuma: ALL... tr NO (JO) were you offered the choice between a re-fund or a re-routing to your tinal destination? i ju oirua nje zgjeanle midis nje shperblimi ose nje mtgte tjeter per ne destinacionin final? E I chose the refund option Une zgiodha opsionin e shperblimit E I was offered a refund for the whole ticket price Mua me eshte ofruar nie shpehlim per cmimin e plote te biletes D lwas offered a refund for non-used flight coupons [please specifyl Mua me eshte ofruar nie shperblim pel.segmentin e udhetimite Pakryer fiu lutem specitikoni] E I chose the rerouting option: tjne zgiodha opsionin e nje nuge tieter: E only refund was offered Vetem shperblimi mu ofrua E Only re-routing to my final destination was oftered lplease specifyl Vetem opsioni i nie rruge tieter ne destinacionin final mu ofrua fiu lutem sqecifikonil

9 llrl CASE YOU WERE DENIED BOARDING AGAINST YOUR WILL: NE MST SE JU NUK JENI PMNUAR NE BORD KUNDREJT VULLNETIT TUAJ: Did the airline call for volunteers? A ka kerkuar kompania ajrore per te dal vullnetar? tr yes (po) D No (Jo) E I don't know (Nuk e di) Did you volunteer not to board the aircraft? A keni mohuar vullnetarisht te hidni ne avion? tr YES (PO) if so, the questions below do not apply (nese po, pyetjet e meposhtme nuk aplikohen) tr NO (JO) in this case, please answer next guestions (ne kete rcst, ju lutemi pergjigjuni pyetkve te meposhtme) Did the airline refuse your boarding for reasons of safety, security, health or inadequate lravel documents? A kane refuzuar linjat ajrore hipjen tuaj ne avion, per shkak te sigurise ajrore, paffezikshmerise, shendetit apo dokumentacionit te pamjaftueshem te udhetimit? o NO (Jo) Cl I don't know (Nuk e di) I i )t' Did you present yourself at the boarding gate not later than the time indicated on your boarding pass? A jeni paraqitur ne porten e nisjes jo me vone se ora e dhene ne boarding pass? Did you receive assistance from the airline or its agent after you were denied boarding? A keni mane asistence nga linja ajrore ose agjenti isaj pasiju eshte mohuar hipja ne avion? tr YEs (Po) What kind of assistance has been provided to you? Cfare lloji asistence ju eshte ofruar? E Meals f Yakte) E Refreshments (Pi'e freskuese) E Place of accommodation (in case the denied boarding resulted in an overnight stay) Akomodim (ne rast se mohimi hipjes ne avion rezulton me nje nate Sendrim) E Transfer between airport and place of accommodation (in case the denied boarding resulted in an overnight stay) Transferim nga aeropofti ne vendin e akomodimit (ne rast se mohimi hipjes ne avbn rezufton me nje nate qendrim) E Communication facilities (telephone calls, fax or messages) Lehtesin komunikimi fthne /i-bfonike, faks ose mesazh i) E Other services (ptease specify): Shetuime te tjera Au tubm specifikoni):

10 Did you receive any financial compensation afier you were denied boarding against your will? A keni mane ndonje kompensim financiar pasiiu eshte mohuar hipia ne avion kundreit deshircs tuaj? tr YES (PO) Amount:... Shuma: ALL... Were you offered the choice between a re-fund OR a re-routing to your final destination? A ju eihte ofruar nje zgjedhje midis np shperblimi ose nie rruge tietet ne destinacionin final? tr YES(PO) E lchose the re-fund option Une zgiodha oqsionin e shqerblimf tr was offered a refund for the whole ticketprice Mua mu otrua nie shperblin per cmimin e plote te biletes E lwas offered a refund for non-used flight coupons Mua mu ofrua nie shperblim per segmentin e udhetimit te pakryer E I chose the rerouting option: Une zgjodha opsbnin e nk rruge tieter E onty refund was offered Vetem shperblimi mu ofrua E Only re-routing to my {inal destination was offered lplease specifyl vetem opsioni i nie nuge tieter dreit destinacionit final me eshte ofruar fiu. lutem specifikonil l0

11 @ NE MST SE JU ESI TE ULUR NIVELI I SHERBIMIT: I had a reservation in: Une kisha nje rezenim ne: E Firsi Class (Kategoria e Pare) E Business Class (Kategoria e Biznesit) I actually travelled in: Une ne te vettete udhetova ne: E Business Class (Kategoia e Biznesit) E Economy Class (Kategoria Ekonomike) Did you receive any refund as a consequence of this downgradlng? A keni pranuar ndonje rimbursim si pasf,h e kesaj ulje ne niveli4e sherbimit? tr YEs (Po) Amount (Shuma): g ALL... What was lhe price of your ticket? Cilishte cmimibnetes tuaj?... ll