Claim Portal

Claim Request Form

Company Name *

Requestor First Name *

Requestor Last Name *

Requestor Email *

Requestor Phone *

Carrier Name *

Claim Type *

Pro/Tracking # *

Check Reference # (If Paid)

Products

Description	Weight	Pieces	Total Price
TOTALS	0	0	$0.00

Are freight charges being claimed? *

Notes

File Upload

Below, upload the Original Product Invoice and pictures of the damaged product if applicable. The acceptable file formats include: TXT, PDF, DOC, DOCX, PNG, GIF, and JPEG.

Note: File upload is required in order to submit a claim request, maximum allowed file size is 25MB.