Danica Claim Form

Danica Claim Form
Hello and thank you for contacting us!

We are sorry your products didn't arrive as expected. Let us make it right!

Please fill out the form below and, once approved, your credit will be emailed to the contact on your account who is set up to receive invoices.
IMPORTANT NOTICE
- All discrepancies must be reported within 5 days of receiving your goods.
- Returns will not be accepted for items damaged in store or for overstocked merchandise.
- If a physical return is needed, a Customer Service Specialist will contact you within 3-5 business days to arrange a return call tag. Unauthorized returns may be refused and credit may not be issued.
CUSTOMER AND ORDER INFORMATION
Account Number*
Company Name*
Contact Name*
Email Address*
Phone Number*
Fax Number
Invoice or Sales Order Number Reference
You can find this reference in your packing slip or invoice
Order Date

MonthDayYear
Sales Rep Name
(If Applicable)
Sales Rep Email
(If Applicable)
CLAIM DETAILS
Please clearly indicate the problem with the product by selecting the appropriate reason code.
Claim Product 1
Item Number*
Item Description*
Quantity*
Claim Reason*
General Comment
Quality Issue or Damage Details*
Please provide additional details about condition of your shipment
Please claim the item you did not receive. Then note in the following fields what you received instead.
Which item did you receive in error?*
How many items did you receive in error?*
Click here to add more itemsNo more items
Claim Product 2
Item Number*
Item Description*
Quantity*
Claim Reason*
General Comment
Quality Issue or Damage Details*
Please provide additional details about condition of your shipment
Please claim the item you did not receive. Then note in the following fields what you received instead.
Which item did you receive in error?*
How many items did you receive in error?*
Click here to add more itemsNo more items
Claim Product 3
Item Number*
Item Description*
Quantity*
Claim Reason*
General Comment
Quality Issue or Damage Details*
Please provide additional details about condition of your shipment
Please claim the item you did not receive. Then note in the following fields what you received instead.
Which item did you receive in error?*
How many items did you receive in error?*
Click here to add more itemsNo more items
Claim Product 4
Item Number*
Item Description*
Quantity*
Claim Reason*
General Comment
Quality Issue or Damage Details*
Please provide additional details about condition of your shipment
Please claim the item you did not receive. Then note in the following fields what you received instead.
Which item did you receive in error?*
How many items did you receive in error?*
Click here to add more itemsNo more items
Claim Product 5
Item Number*
Item Description*
Quantity*
Claim Reason*
General Comment
Quality Issue or Damage Details*
Please provide additional details about condition of your shipment
Please claim the item you did not receive. Then note in the following fields what you received instead.
Which item did you receive in error?*
How many items did you receive in error?*
Click here to add more itemsNo more items
Claim Product 6
Item Number*
Item Description*
Quantity*
Claim Reason*
General Comment
Quality Issue or Damage Details*
Please provide additional details about condition of your shipment
Please claim the item you did not receive. Then note in the following fields what you received instead.
Which item did you receive in error?*
How many items did you receive in error?*
Click here to add more itemsNo more items
Claim Product 7
Item Number*
Item Description*
Quantity*
Claim Reason*
General Comment
Quality Issue or Damage Details*
Please provide additional details about condition of your shipment
Please claim the item you did not receive. Then note in the following fields what you received instead.
Which item did you receive in error?*
How many items did you receive in error?*
Click here to add more itemsNo more items
Claim Product 8
Item Number*
Item Description*
Quantity*
Claim Reason*
General Comment*
Quality Issue or Damage Details*
Please provide additional details about condition of your shipment
Please claim the item you did not receive. Then note in the following fields what you received instead.
Which item did you receive in error?*
How many items did you receive in error?*
Click here to add more itemsNo more items
Claim Product 9
Item Number*
Item Description*
Quantity*
Claim Reason*
General Comment*
Quality Issue or Damage Details*
Please provide additional details about condition of your shipment
Please claim the item you did not receive. Then note in the following fields what you received instead.
Which item did you receive in error?*
How many items did you receive in error?*
Click here to add more itemsNo more items
Claim Product 10
Item Number*
Item Description*
Quantity*
Claim Reason*
General Comment*
Quality Issue or Damage Details*
Please provide additional details about condition of your shipment
Please claim the item you did not receive. Then note in the following fields what you received instead.
Which item did you receive in error?*
How many items did you receive in error?*
Did your shipment include air pillows for protection?*
What was the condition of the air pillows?*
Please provide pictures, if possible
Please specify
Additional Comments
(Optional)
Please upload photos of any damages, including the condition of the air pillows, shipment, and boxes, if applicable.

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Danica Claim Form

CUSTOMER AND ORDER INFORMATION

CLAIM DETAILS

Claim Product 1

Claim Product 2

Claim Product 3

Claim Product 4

Claim Product 5

Claim Product 6

Claim Product 7

Claim Product 8

Claim Product 9

Claim Product 10