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1 Instructions2 Customer Information3 Inventory Claim List4 Review5 Confirm & Submit What You Need to File a Claim We are sorry you find it necessary to report a claim. To expedite the review, please ensure to follow the necessary steps below. This will enable us to speed up the process and bring this to resolution quickly. Thank you for your cooperation in this matter. Steps Required upon Filing a Claim Attach photos and substantiation (receipts) of the damaged items - photos and receipts may expedite your claim and eliminate the need for a physical inspection Retain items for inspection including all packing materials - damaged items must be made available in the event of a physical inspection All claims must be filed within 9 months from the delivery date. Claims received after the 9-month claim filing deadline cannot be accepted. The 9-month claim filing deadline does not apply to government, military, certain national account contracts and intrastate (within the state) moves for Oregon. Regulations for Oregon intrastate moves require that any claim for loss, damage or delay must be submitted in writing by claimant and received by carrier within 3 months. Complete all unpacking and examine all items before submitting your claim To prevent delays, please complete all fields for each item: Provide Inventory numbers Describe the extent, location, and nature of damage Give a brief description of each item (make and model number/s if applicable) If the claimed item is missing, enter 'missing' If packed item, indicate who packed and whether or not there is carton damage Enter the amount you are claiming in the settlement field - without this amount the claim form will be considered incomplete Indicate the item's replacement cost for same or like kind item 8. Attach PHOTOS of the damaged items Please DO NOT discard items or have any items repaired -items that are not available in the event a physical inspection is required may not be considered Please ensure your transportation charges have been paid in full - the carrier cannot settle a claim until all charges have been paid We are very sorry for any damage that may have occurred during your move.To submit a claim, please enter the information below. Order Number*Name* First Name Last Name Primary Phone*Secondary PhoneEmail* Preferred Method of Contact*EmailPhoneBest Time to Contact You* AM PM Anytime Current Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Pickup Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please Indicate Type of MoveInterstateIntrastateLocalNot SurePick-Up Time : HH MM AM PM Pick-Up Date* Delivery Time : HH MM AM PM Delivery Date* Where Was Shipment Picked Up?*ResidenceWarehouseDid employer pay for move?*YesNoWhat was declared value protection?* $0.60/LB. $1.25/LB. Full Value Deductible Don't Know Enter Items for Your Claim Add Claim Item*Inventory Claim List*1. Item Inventory Number*2. Description of Item*3. Damage Description* (if missing, enter 'Missing')4. If packed item, who packed* (enter 'customer', 'mover', or 'not packed')5. If packed item, was there carton damage* (enter 'yes', 'no', or 'not packed')6. Amount claimed*7. Original cost8. Age of item9. Weight of item10. Item manufacturer name11. Item model or serial number Upload Images Drop files here or If you have an issue uploading images, please save the images and you can email them to our claims team directly later in the claims process. [Max: 10MB]If you experience image upload problems please submit form and wait for representative to contact you Checkit I am the person filing this claim, identified as the Claimant, and the owner of the property described. I did not cause or contribute to the damage set forth herein. All statements made in this statement of claim are true and correct to the best of my knowledge and belief, and constitute my complete and entire claim. I have indicated a specified or determinable amount for each article claimed. No material information has been withheld. Department of Transportation (DOT) regulations require that any claim for loss, damage or delay must be submitted by claimant and received by carrier within nine months from date of delivery (with exceptions to government, military, certain national account contracts and intrastate (within the state) moves for Oregon).I have read and agree to the above terms* I certify that the information I have given on the application is complete and correct. CAPTCHAEmailThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.
We are sorry you find it necessary to report a claim. To expedite the review, please ensure to follow the necessary steps below. This will enable us to speed up the process and bring this to resolution quickly. Thank you for your cooperation in this matter.
Steps Required upon Filing a Claim
We are very sorry for any damage that may have occurred during your move.To submit a claim, please enter the information below.
Add Claim Item*
Chipman Relocation & Logistics U.S. DOT No. 00233667 | United Van Lines, LLC U.S. DOT No. 077949 | Mayflower Transit, LLC U.S. DOT No. 125563 | CA PUC No. MTR0114272 | OR PUC No. 19604 | WA PUC No. HG6985