Today's Date

Contact Name

Dealer Name

Phone

Sales Order #

Section II. Reason for Claim:

Wrong Product Missing Parts/Hardware Manufacture's Defect Other

Section III. Freight Damage:

Claims must be filed within 15 business days from date of delivery. Pictures of damaged good and original cartons are required and must accompany your claim. Failure to include these items will cause delay or denial of your claim.

Freight Damage Noted Upon Arrival:

Was the Box Damaged?

Yes No

Was Shipment Refused or Visible Damage?

Yes No

Concealed Damaged:

Was Damage Noted on Bill of Lading?

Yes No

Are Items Still in Original Packaging?

Yes No

Section IV: Explanation and Photos:

Brief Explanation of Issue:

Max size: 15Mb per photo

Section V: Shipping of Replacements:

Company Name ATTN

Address Line 1 Address Line 2

City State Zip

Country

DAMAGE & RETURN CLAIM FORM

Section I. General Information:

Section II. Reason for Claim:

Section III. Freight Damage:

Section IV: Explanation and Photos:

Section V: Shipping of Replacements:

Editing Quote

Editing Quote

GSA Quote

DAMAGE & RETURN CLAIM FORM

Section I. General Information:

Section II. Reason for Claim:

Section III. Freight Damage:

Section IV: Explanation and Photos:

Section V: Shipping of Replacements: