• Statement of Claim

  • All claims submitted are subject to the terms and conditions on the bill of lading, and subject to the valuation of the goods as declared on the face of the bill of lading.

  • Details of Claim

  • Please give full particulars to the best of your knowledge. In describing articles give as much information as possible such as: colour, finish, kind of material, pattern, design, model number, serial number, trade number, trade name, manufacturer's name, etc. If purchase invoices are available, submit support of valuation.

    FOR YOUR INFORMATION HOUSEHOLD GOODS GENERALLY DEPRECIATE BETWEEN 10% AND 15% PER YEAR. WE RESERVE THE RIGHT TO REQUIRE NOTARIZED STATEMENT OR AFFIDAVIT. In order to process this claim all columns below must be completed in FULL DETAIL. This claim represents all loss or damage incurred while shipment identiied above was in the care and control of HIGHLAND VAN & STORAGE LTD. / SUMMIT MOVING & STORAGE / DOWELL'S MOVING & STORAGE

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  • The undersigned attests that the statements above and the documents attached are true and correct and constitute the complete and entire claim. It is further agreed that this form does not constitute an admission or responsibility by the carrier, but merely an assistance in presenting the claim for consideration. Upon complete of the repairs, replacement and/or cash settlement of any items named above accepted as liability by the carrier, the undersigned hereby releases and forever discharges HIGHLAND VAN & STORAGE LTD. / SUMMIT MOVING & STORAGE / DOWELL'S MOVING & STORAGE and the carrier from any further claim under the contract.

  • This field is for validation purposes and should be left unchanged.