Instructions for Completing the Statement of Claim

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Statement of Claim Form Download

You must have the following documentation ready for reference to complete the Statement of Claim:

• Call us at 800-343-3500 and request that a claim form be mailed to you.
• Download a copy of the STATEMENT OF CLAIM form. You can complete the form on-line and then print the form or download a copy of a blank form, complete it manually and then mail or fax it to one of the addresses below.

• Registration Number - This number can be found on your Bill of Lading. It begins with PA and is followed by a series of seven numbers.
• Claim Number - Once a completed claim form is received, Arpin Van Lines will assign you a claim number. Always use this number to refer to your claim. So that we may process your claim quickly, please reference this number on all supporting documentation.
• Declared Valuation Protection - Check your Bill of Lading or contact your Arpin representative to determine what your declared valuation protection was.
• Warehouse Storage - Check the appropriate box and type in the location where your goods were stored.
• Corporate Move - Did your employer pay for your move? This is important to note as most companies have individual terms / conditions to which we must adhere when processing a claim.
• For each item claimed as damaged or lost:
  • Inventory Number - You'll find this number on the tag or sticker that the driver put on the piece of furniture or box during the inventory process.
  • Article - Please give a complete and accurate description of the item damaged or presumed missing. Do not remove inventory stickers from the damaged item(s). Keep all damaged items and shipping boxes. These items should be made available for inspection. If we replace an item that is lost or damaged, we maintain salvage rights on the item and will make arrangements to remove it within 30 days of settlement.
  • Description of Damage or Loss - Give a complete description of the extent of the damage to the item. Tell us the location of the damage as well. Claims for missing items will require a tracer and investigation. You will be notified of the results. If negative, you may be asked to submit further documents to process your claim.
  • Estimated Weight - The approximate weight of the item or carton you are claiming as missing or damaged.
  • Age or Date Purchased - Either provide the approximate age of the item and / or purchase date of the item. If the item is a family heirloom, list the source if known.
  • Original Cost - Please provide the approximate amount you paid for the item.
  • Replacement Cost Today - Enter today's cost of replacing the item of like kind and quality.
  • Estimated Cost To Repair (Amount Claimed) - Enter the amount you are requesting for full settlement or list the repairs required. The adjudicator assigned to process your claim will contact you to schedule any necessary inspections or repairs.