* Name 

* Address 

Postcode, city 

Country 

* E-mail 

Telephone number 

1) Passengers who believe they have a valid complaint against an airline regarding denied boarding, downgrading, cancellation or long delay to a given flight should first submit such a complaint to the airline operating the flight concerned.

2) Should the airline fail to provide you with a reply within 8 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 body² in the Member State³ where the incident took place.

3) If the incident took place at an airport of departure outside the EU, you may contact the national enforcement body in the Member State of flight destination.

4) This complaint form is to be used only for cases concerned with denied boarding incident, downgrading, cancellation, or long delay of a flight.

¹ "Regulation 261/2004 applies to all flights operated by any airline from any EU airport and flights to an EU airport operated by any EU airline"
² A list of National Enforcement Bodies and further information on EU passenger rights may be found at: http://ec.europa.eu/transport/themes/passengers/air/
³ or Iceland, Norway, Switzerland.

* Airline 

* Booking reference 

* Flight number 

* Ticket number 

* Airport of departure 

* Airport of arrival 

Connecting airport (if any) 

* Date of your flight 

* Airport(s) where the incident occurred 

* Scheduled time of departure 

Actual time of departure 

* Scheduled time of arrival 

Actual time of arrival 

a) Name of Passenger 

Adult, Child or Infant  - Select - Adult Child Infant (less than 2 years)

Please indicate

Special assistance 

Please indicate if it was required

b) Name of Passenger 

Adult, Child or Infant  - Select - Adult Child Infant (less than 2 years)

Please indicate

Special assistance 

Please indicate if it was required

c) Name of Passenger 

Adult, Child or Infant  - Select - Adult Child Infant (less than 2 years)

Please indicate

Special assistance 

Please indicate if it was required

d) Name of Passenger 

Adult, Child or Infant  - Select - Adult Child Infant (less than 2 years)

Please indicate

Special assistance 

Please indicate if it was required

e) Name of Passenger 

Adult, Child or Infant  - Select - Adult Child Infant (less than 2 years)

Please inficate

Special assistance 

Please indicate if it was required

''Long delay'' means when a flight does not depart until after the scheduled departure time by:
i) two or more hours, for flights of up to 1500 km;
ii) three or more hours for intra-EU flights of 1,500 km and longer, or for other flights between 1501 and 3000 km
iii) four or more hours, for all other flights.

''Cancellation'' means the non-operation of a flight that was previously planned

''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 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 to deny passengers boarding, such as reasons of health, safety, and/or security, or in cases of inadequate travel documentation.

''Downgrading'' means the passenger involuntarily travelled in a class of service lower than the class of service for which they had a confirmed reservation

Did the passenger(s) hold a confirmed reservation on the flight concerned? 

Did the passenger(s) present themselves at the check-in desk at the latest at the time indicated by the airline (or if no time was indicated: not later than 45 minutes before the published departure time of the flight)? 

Did the passenger(s) present themselves at the boarding gate before the time indicated on the boarding card? 

* Did the airline provide the passenger(s) with information on their rights? 

I hereby declare that all of the information provided in this form is true and accurate in all respects and for all the passengers concerned.

* Did you receive assistance from the airline or its agent during your long delay? 

* If yes, what kind of assistance has been provided to you? 

If other services, what kind? 

If the delay of your flight was of 3 hours or more after the arrival time originally scheduled, did you receive any financial compensation? 

If yes, what is the amount? 

If the delay of your flight was longer than 5 hours, did your flight still serve a purpose? 

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? 

If the delay of your flight was longer than 5 hours. In case you decided not to continue your journey, were you offered a refund? 

If yes, what was the refund? 

Were you informed about the fact that your flight was cancelled? 

If it was before you arrived, 

Were you informed about the reason why your flight was cancelled? 

If yes, what was the reason given to you? 

Were you offered an alternative flight? 

Did you receive assistance from the airline or its agent at the airport? 

If yes, what kind of assistance has been provided to you? 

If yes, other services 

Did you receive any financial compensation for this cancellation? 

If yes, what is the amount 

Were you offered the choice between a re-fund OR a re-routing to your final destination? 

If yes 

If you chose the refund option 

If you where offered a refund for non-used flight coupons 

If no 

If only re-routing to my final destination was offered 

Did the airline call for volunteers? 

Did you volunteer not to board the aircraft? 

Did the airline refuse your boarding for reasons of safety, security, health or inadequate travel? 

Did you present yourself at the boarding gate not later than the time indicated on your? 

Did you receive assistance from the airline or its agent after you were denied boarding? 

If yes, what kind of assistance has been provided to you?  Meals Refreshments Place of accommodation (in case the denied boarding resulted in an Transfer between airport and place of accommodation (in case the denied Communication facilities (telephone calls, fax or e-mail messages)

Did you receive any financial compensation after you were denied boarding against your will? 

If yes, amount in euros 

Were you offered the choice between a re-fund OR a re-routing to your final destination? 

If yes - I chose the rerouting option 

If no - Only re-routing to my final destination was offered 

I had a reservation in 

I actually travelled in 

Did you receive any refund as a consequence of this downgrading? 

If yes, amount in euros 

What was the price of your ticket? 

* Passangers claim Complaint has been sent to: 

Other 

* Passenger claims for: 

Other 

 

 

 

 

 

 

 

Message 

I hereby certify that I am sending this application in my name and allow the parties responsible for the implementation of Regulation (EC) No 261/2004 to represent me, as far as their power extends, in communicating with the above air carrier and to gain access to personal information relating to me and held by the air carrier.

With this request (application/form), I consent to the processing and control of the submitted information. The Icelandic Transport Authority will use the information in accordance with applicable laws and regulations on the processing of personal data.