Thank you for choosing Moving Buddies to complete your move. We sincerely regret that your move was not to your complete satisfaction as it has come to our attention that damage and/or loss may have occurred. Providing complete information on this form will enable us to process your claim promptly.
- Thoroughly answer all questions to avoid unnecessary delay in concluding your claim.
- Include detailed information to the best of your knowledge regarding lost or damaged items. When describing articles, give as much information as possible such as color, kind of material, model numbers, trade/name, manufacturer, etc.
- Please remember any articles found damaged must be kept available for inspection (including the container in which it was packed).
Please read the following Statement of Claim:I AM THE OWNER OF THE PROPERTY DESCRIBED. I DID NOT CAUSE OR CONTRIBUTE TO THE DAMAGE SET FORTH HEREIN. ALL INFORMATION PROVIDED BY ME IN THIS STATEMENT OF CLAIM AND ANY DOCUMENTS PROVIDED ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF AND CONSTITUTE MY COMPLETE AND ENTIRE CLAIM. NO MATERIAL INFORMATION HAS BEEN WITHHELD.
SOME MOVES MAY HAVE SPECIFIC CLAIM OR INSURANCE FILING REQUIREMENTS. LOCAL AND INTRASTATE MOVES HAVE SPECIFIC TIME LIMIT RESTRICTIONS FOR FILING A CLAIM. PLEASE CONSULT WITH YOUR MOVE COORDINATOR OR RELOCATION MANAGER TO VERIFY SPECIFIC POLICIES AND/OR REQUIREMENTS.
SALVAGE PROCEDURE: All damaged items which are replaced, or for which the full replacement value will be paid, become the property of the Move Manager or Transportation Provider settling the claim. The Move Manager or Transportation Provider will have 30 calendar days from the claim settlement date to take possession of the salvage item(s) with a single item value of $50.00 or more. If the salvageable item is unavailable to the Move Manager or Transportation Provider, 25 percent of the item’s (items’) replacement value will be deducted from the settlement offer for that item.
DO NOT DISCARD ANY CLAIMED ITEMS OR DAMAGED CARTONS UNTIL WE HAVE HAD AN OPPORTUNITY TO INSPECT THEM. DISCARDING OR UNAUTHORIZED REPAIRS TO ANY ITEMS PRIOR TO INSPECTION MAY AFFECT YOUR CLAIM SETTLEMENT.
In submitting this form electronically, I certify and agree that my name in the space below is true and correct and by such submittal I bind and legally obligate myself to the same extent as I would by signing my name on a printed paper version of this form.
I have full knowledge of the penalties involved for willfully making a false, fictitious or fraudulent claim (Section 287 or Title 18, United States Code, provides a maximum fine of $10,000.00 or imprisonment for five years or both).