Lost Ticket Refund Application

One ticket per application. Claims will be processed within 90 days

United Airlines Refund Department
Attn.: Processing Department
P.O. Box 4607, Dept. NHCRF
Houston, TX 77253

Select your scenario:

  • Complete only if a) the PNR is active, b) the original ticket number is available.
  • Complete only if all conditions of option 1 are not met
Portion of Ticket Lost
Flight No./Departure Time
Where Purchased
Location Purchased/Travel Agency Name/Address
Form of Payment of lost ticket
Payment Type
Was any portion of the ticket used before loss?
Flight No./Departure Time

Ticket is missing for the following reasons

By Airline Personnel at:
Ticket not received by customer for:

Replacement Ticket Information

Was Service Charge Collected?
Was Replacement Ticket Purchased?
Pay refund to:
Refund to original form of payment if no box is checked.
Was Service Charge Collected?
Form of Payment of lost ticket
Flight No./Departure Time

Claims will not be processed until ticket numbers are identified. Unsigned applications will not be processed. If original ticket was paid for with credit card, please allow up to one additional month for credit to be posted to your credit card statement. In consideration of the refund payment or the issuance of replacement ticket, the applicant will reimburse United Air Lines, Inc. for any loss or damage sustained due to the use of the ticket’s claimed unused portion for transportation or refund and applicant authorizes United Air Lines, Inc. to charge any such loss or damage against the credit/debit card referred above. United Air Lines, Inc. is not responsible for tickets presented for transportation or refund by other than the person whose name is designated as the traveler and United Air Lines, Inc. assumes no responsibility for determining identity. This claim will be given consideration provided that the application is submitted within 12 months after you purchased the lost ticket. The applicant claims that the above referenced ticket cannot be found and has not been and will not be transferred to any other person. Upon finding the lost ticket, the applicant will immediately submit the ticket to United Air Lines, Inc. with a statement that a lost ticket application has been filed. For claims made against tickets paid by check, send copies of both sides of the cancelled check. For claims made against tickets purchased from a travel agency, contact the agency for a copy of the lost ticket. A non-refundable service charge will be assessed for handling this lost ticket/indemnity application (amount subject to change without notice).

Please read the terms of this application before signing