Commercial Claims

Job #
Company name*
Shipment type*
First name*
Last name*
Date loaded*
MM slash DD slash YYYY
Date delivered*
MM slash DD slash YYYY
From (City & State)
City State
To (City & State)
City State
Address
Street Address Address Line 2 City State ZIP Code
Home phone
Work phone
Email*
Valuation Prior To The Move Was?
- Option 1 - Full Replacement Value Protection
- Option 2 - Released value .60 cents per pound. (This option has a $100 Deductible)
Protection Amount
Deductible
Total
$0.00
Cartons Packed By
- Able Moving and Storage
- Customer
Cartons Unpacked By
- Able Moving and Storage
- Customer
Storage Location
*If applicable
Any External Damage To Carton
- Yes
- No
Start Of Storage
*If applicable
MM slash DD slash YYYY
End Of Storage
*If applicable
MM slash DD slash YYYY
When was damage discovered?
MM slash DD slash YYYY
Who discovered damage?

Inventory #	Article	Description of damage	Est. Weight	Date Acquired	Amount Claimed	Est. Repair Cost	Damage

Claim Details