Get an instant quote

Claim Form

We are very sorry for any damage that may have occurred during your move. To submit a claim, please enter your information below, and we will get in touch with you as soon as possible.

All fields marked with an asterisk (*) are required.

First Name:*

Address:*

City:*

Phone Number:*

Email Address:*

Order # / Bill of Lading #:*

Pickup Date:*

Last Name:*

Apt/Suite#:

State:*

Zipcode:*


Work Phone Number:

Name of Employer:

Delivery Date:*

Origin Address:*

Delivery Address:*

Was shipment in a warehouse?*

Are you the owner of the goods in question?*

Have all transportation/storage charges been paid?*

Inventory #

Article Name

Description of Damage

Purchase Date

Purchase Price $

Claim Amount $

Customer Signature:*

Information provided is not sold or shared.