Your Name
*
First Name
Last Name
Policy Number
This can be found on your policy schedule.
Company Name
Are you VAT registered?
*
Yes
No
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: 00000000000.
Your Address
*
Street Address
Street Address Line 2
City
State / Province
Post Code
Claim Type
*
Loss
Theft
Damage
Incident Date
*
-
Day
-
Month
Year
Date
Total value of goods in transit
*
Estimated claim value
*
Collection Address
*
Street Address
Street Address Line 2
City
State / Province
Post Code
Delivery Address
*
Street Address
Street Address Line 2
City
State / Province
Post Code
Who packed the Goods?
*
Removal Company
Owner Packed
How were the goods packed
*
Description of what happened
*
Do you accept liability for the claim against you?
*
Photos of Damage
Photos of Damage
Photos of Damage
Evidence of value (Purchase Receipts, Repair Invoice etc )
Copy of the agreement to go ahead with the removal (Invoice, Booking Confirmation etc)
Copy of the Written Claim against you (Text message notifying you of damage)
Valued Inventory
Your Terms and Conditions agreed for the move
Browse Files
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