Free claim letter  32
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LETTER OF INTENT TO CLAIM

DATE:

ATTENTION: CLAIMS DEPT
7890 EXPRESS STREET
BURNABY, BC
V5A 1T4
CLAIMANT'S INTERNAL REF. #

E-MAIL: [email protected]
PHONE: 1-866-223-8319
FAX: 604-297-0706

(Optional - for Claimant's Use Only)
CLAIMANT DETAILS
COMPANY NAME:
ADDRESS:
CITY / PROV.

POSTAL CODE:

TELEPHONE #:

FAX #:

MAILING ADDRESS: (If different from above)
CONTACT NAME:

EMAIL ADDRESS:

I am making a claim for the amount of $

which represents the value of the goods

shipped on (Date:)

on Loomis Express Waybill #

Content Details:
The shipment was (choose one)

COMPLETELY or

PARTIALLY

DAMAGEDor

LOST

CONTENTS MISSING
FROM BOX / ENV.

The goods were shipped:
(Shipper Details)
FROM:

(Consignee Details)
TO:

ADDRESS:

ADDRESS:

PHONE #:

PHONE #:

EMAIL:

EMAIL:

REQUIRED ATTACHMENTS:
Claim may not be considered if applicable items are not received.
Copy of the ORIGINAL PURCHASE INVOICE (not your selling invoice); or the manufacturing cost, or
percent markup to substantiat