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Damages Claim Form
Removal of single or multiple items
Free dismantle & reassemble
Residential & commerical relocations
On time guarantee
Job Number
Postal address
Contact First Name
Contact Surname
Contact Number
Email
Date of loss/damage
Goods moved from
Goods moved to
When was loss/damage first discovered?
Please provide details of the loss/damage incident?
Were goods professionally packed?
Yes
No
Were details of loss/damage noted at time of delivery?
Yes
No
Have you notified carrier of loss/damage?
Yes
No
Description of items to be claimed
Details of loss/damage
Can the item be repaired?
Yes
No
Amount claimed (AUD)
Total Amount Claimed
Please attach
before
photos:
Please attach
after
photos:
Declaration
I declare that to the best of my knowledge and belief the information in this form is true and correct and I have not withheld any relevant information. I understand that Insurers do not admit liability by the issue of this form.
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