Primo Moving Company
Loss and Damage Claim Form
Customer Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
New Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Old Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Move Date
*
-
Month
-
Day
Year
Date
Statement of Claim
Describe and list damaged item(s). Please include receipts or links to item or similar item if possible.
1.
Item Description
Description of Loss/ Damage
Item Weight
Date of Purchase/ Age of Item
Cost to Replace
Pictures of Damaged Item
Browse Files
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Choose a file
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of
2.
Description of Loss/ Damage
Item Description
Item Weight
Date of Purchase/ Age of Item
Cost to Replace
Pictures of Damaged Item
Browse Files
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Choose a file
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of
3.
Item Description
Description of Loss/ Damage
Item Weight
Date of Purchase/ Age of Item
Cost to Replace
Pictures of Damaged Item
Browse Files
Drag and drop files here
Choose a file
Cancel
of
4.
Item Description
Description of Loss/ Damage
Item Weight
Date of Purchase/ Age of Item
Cost to Replace
Pictures of Damaged Item
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Choose a file
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of
5.
Item Description
Description of Loss/ Damage
Item Weight
Date of Purchase/ Age of Item
Cost to Replace
Pictures of Damaged Item
Browse Files
Drag and drop files here
Choose a file
Cancel
of
6.
Item Description
Description of Loss/ Damage
Item Weight
Date of Purchase/ Age of Item
Cost to Replace
Pictures of Damaged Item
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Drag and drop files here
Choose a file
Cancel
of
7.
Item Description
Description of Loss/ Damage
Item Weight
Date of Purchase/ Age of Item
Cost to Replace
Pictures of Damaged Item
Browse Files
Drag and drop files here
Choose a file
Cancel
of
8.
Item Description
Description of Loss/ Damage
Item Weight
Date of Purchase/ Age of Item
Cost to Replace
Pictures of Damaged Item
Browse Files
Drag and drop files here
Choose a file
Cancel
of
9.
Item Description
Description of Loss/ Damage
Item Weight
Date of Purchase/ Age of Item
Cost to Replace
Pictures of Damaged Item
Browse Files
Drag and drop files here
Choose a file
Cancel
of
10.
Item Description
Description of Loss/ Damage
Item Weight
Date of Purchase/ Age of Item
Cost to Replace
Pictures of Damaged Item
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of
Primo Moving customarily takes every precaution to ensure that while your shipment is
in our possession, no items are lost, damaged, or destroyed. However, despite our best
precautions, articles are sometimes lost or destroyed during the moving process.
According to The Federal Motor Carrier Safety Administration’s (FMCSA)
have the right to file a claim with your mover to be compensated for loss or damage.
You have 9 months from the date of delivery (or in the event of loss for the entire
shipment, from the date your shipment should have been delivered) to file your claim. The claim must be submitted in writing to your mover or to your mover’s third party
company for the claim processing. After you submit your claim, your mover has 30 days
to acknowledge receipt of it. The mover then has 120 days to provide you with a
disposition. (Don't worry we will get it processed and taken care of ASAP)
On behalf of everyone at Primo Moving, we are sorry you have to be here to fill out a claim. We do our best to help and take care of everyone we move and of course, your belongings as well.
Best Regards,
The Primo Moving Team
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