Contact Action Moving Services

Statement of Claim: Please use this form to register a claim for loss or damage to items transported intrastate and local by Action Moving Services.

Instructions:

1. Complete part A of the form with all available background information.

2. Identify your lost/damaged items accurately and completely in part B of the form, noting the inventory number, descriptions of the item and damage, and the item's weight, cost, date acquired and the amount you are claiming.

3. If you are making a claim for lost items, please itemize contents of containers and include evidence of ownership for all items claimed as lost.

4. Please include copies of your order for service, bill of lading and inventories.

5. Complete part C of the form.

Part A

Name

Part B

Part C

The information contained in this loss/damage claim is true and correct to the best of my knowledge and belief, and constitutes my complete and entire claim for loss/damage.

Current information

Name

Address