Claim form for lost or damaged shipments - FedEx
Claim form for lost or damaged shipments
Sender or Shipper's Name / Contact Company Address City Country Phone Email
State / Province ZIP / Postal Code Fax
Recipient's or Consignee's Name / Contact
Company
Address
City
State / Province
Country
ZIP / Postal Code
Phone
Fax
Email
House Bill of Lading or House Airway Bill No.
Shipment Information
Loss Complete Partial
Ship date
No. of packages
FedEx Trade Networks claim number (office use only)
Qty of Packages
Item No.
Item Description
Weight
Claimed Amount
Damaged
Please retain all packaging and merchandise until your claim is resolved.
Contents of shipment Describe damage to outer packaging
Describe inner packaging
Describe damage to contents
Salvage Claimant Information
E-mail SUBMIT
Declared value
(The declared value when tendered
to FedEx Trade Networks)
$
Merchandise value (Original purchase value and/or cost to repair) $
Declared value for customs
(International shipments only)
$
Customer remarks
If your claim is filed for damage, please note that claimants have a legal obligation to mitigate claims and reduce damage as much as possible. If mitigation through repair or salvage is not possible, please explain
why. Damaged goods and packaging should be held until the investigation is complete.
I accept that the foregoing statement of facts is hereby certified as correct. Signature (for fax or mail) Claimant's Name (please print) Claimant's Address City Country E-Mail
Date Internal Reference No.
Phone State / Province ZIP / Postal Code Fax
Please return the completed form and required proof of loss and value to claims@ftn.. Proof of loss should include original commercial invoice, packing list, and signed delivery receipt noting exceptions. For damage claims, please include photos of both the damaged packaging and its contents.
31581PL 1/09 FTN update 12/17
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