Damage Claim Form

DAMAGE CLAIM FORM

ALL CLAIMS MUST BE REPORTED WITHIN 30 DAYS.

PLEASE KEEP DAMAGED MERCHANDISE IN ORIGINAL PACKAGING FOR SHIPPER INSPECTION.

ALL RETURNS REQUIRE AUTHORIZATION #

WE APOLOGIZE FOR ANY ISSUES WITH YOUR SHIPMENT. YOUR HELP IN COMPLETING THIS FORM IS APPRECIATED
Customer Name*
Contact Name*
E-mail*
Company Name
Customer Number*
Invoice Number
Order Number
Date*

MonthDayYear
1) Product Number*
Product Description*
Qty Claimed*
Issue*
2) Product Number
Product Description
Qty Claimed
Issue
3) Product Number
Product Description
Qty Claimed
Issue
Other Issue
CreditReplace
Describe Issue*
# of boxes Received
Is Outer Box Damaged?
Is Inner Box Damaged?
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