Swamp Rabbit Moving Claim Form
Claim Number Auto Populates. Any fields with with red * Asterisk are required.
Your Claim Number
*
Customer Information
Please provide the contact information that was used to schedule your move.
Your Name
*
Your Email
*
Date of Move
*
-
Month
-
Day
Year
New Address (Address of Relocation)
*
Nature of Claim
*
Please Select
Damaged
Missing Items
Billing
Crew Issues
Management Issues
Timeliness
Communication
Other
If *other, please explain
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Item / Article List
Please provide a complete list of the items or articles being referenced in the claim.
Inventory List
*
Requested Total Dollar Value of Claim
Please provide us with the total requested dollar value of the items listed on the claim.
Upload Supporting Documents (Images of damaged items, receipts, etc)
Browse Files
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Choose a file
Please provide as much supporting documentation as possible including photographs of damaged items, description of damages and receipts. In the event no receipts are available the burden will be upon the owner of the items to provide proof of value. Swamp Rabbit Moving & Storage reserves the right to make a final determination with regards to value.
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Additional Information
Please provide any additional information that is relevant to the claim. Upon agreement and submission of this form, our team will review the information provide and contact you with any questions and/or resolutions.
Additional Claim Details and Specifics.
Please provide any additional information that is relevant to the claim.
Signature
*
Submit Claim
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