Storage Shield Inc. Claims Form

Claims Form

Personal Information
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Storage Facility Information
Address
City, State, Zip
Manager Name
Email Address
Facility Phone
Claim Information
Date Discovered

MonthDayYear
Date
Date of Loss

MonthDayYear
Date
Was the facility manager notified?
Has a claim been filed with insurance?
Unit #
Name of Manager Notified
If burglary, has law enforcement been notified?
Has police been notified?
If Yes, name of Law Enforcement Agency:
Case #
Describe Loss (*Burglary/Vandalism Loss requires a Police Report & Pictures/Documentation by Management Identifying Forcible Entry)
Include pictures of damage

Browse Files

Cancelof
Inventory
Please include item description, year purchased, cost of new (must include all 3 answers):
Amount for replacement of same or similar:
Please verify that you are human
Should be Empty:

Claims Form