Claim Form: Specialized/Logistics

Statement of Claim
Customer Information

To fill out this Statement of Claim form, you will need to reference your copy of the following items:

  1. Household Goods Carrier's Bill of Lading and Freight Bill.
  2. Household Goods Descriptive Inventory.

In all cases, keep damaged articles (including shipping containers) for inspection. Arrangements will be made to inspect and estimate damage to the articles you have claimed.

You may obtain help and explanations for completing this form by clicking on the links next to each item. After reading the help, please use your brower's "BACK" button to return to this form; then continue on to the next item.

This claim form is for goods handled by our Specialized/Logistics team.  To make a claim on household or corporate goods, please click here.


* - Indicates a required field.
Your First Name
Your Last Name
Customer First Name *
Customer Last Name *
Title/Dept
Company Name (if applicable)
Address
City
State/Province
Zip/Postal Code
Your shipment's 5-digit (Canada) or 6-digit (U.S.) Registration Number: *
(If you do not have this number, please contact the party that arranged transportation or your Allied booking agent.)
( ex. 333-444-5555 )
Work Phone - Extension
Wireless or Cell Phone
Email Address *
Transported To:
(Destination Address)
Company Name (if applicable)
Address
City
State/Province
Zip/Postal Code
Transported From:
(Origin Address)
Company Name (if applicable)
Address
City
State/Province
Zip/Postal Code
The date your items were loaded onto the truck:  (mm/dd/yy)
The date your items were delivered:  (mm/dd/yy)
Was your shipment stored in a warehouse?
If 'YES', where?
Agent Name
City
State/Province
What type of valuation was your shipment moved under?
Select One:
  
   
  

*
Copyright © 1995-2008, Allied Van Lines, Inc. All Rights Reserved. U.S. DOT No. 076235
*