[Today’s Date]
[Customers Details]
Dear [name],
LODGING A CLAIM WITH FREIGHT LINES LTD
Please find attached a copy of the Freight Lines Ltd Customer Claim Application Form.
To enable us to respond to your claim quickly, please ensure that all sections of the form are completed. When you send the completed form to us, also include all supporting documentation.
Once we receive your completed form and supporting documentation, we will send you a claim acknowledgement that will include your Claim Reference Number. If you have any queries about your claim please quote this number.
Please note: if your claim is accepted, the damaged freight must be made available for our collection.
Please be aware that under the Carriage of Goods Act 1979, that our liability is limited to $2000 per unit of goods lost or damaged. We recommend that you contact your General Insurer for claims exceeding this amount.
If your claim is accepted, you will need to forward us an Official Tax Invoice [that contains details of the damaged and/or missing freight, the consignment number, and the cost price of the goods] in addition to a copy of the Commercial Sales Invoice that you provided to your customer which provides proof of the cost of the damaged/missing freight.
The provision of a Customer Claim Application Form or a Claim Reference Number does not mean that any liability is accepted by Freight Lines Ltd for your claim.
If you require further information or assistance, please do not hesitate to contact me on:
Landline:
Fax:
Email:
Postal:
Yours sincerely
FREIGHT LINES LIMITED
Claims Officer
Customer Claim Application Form
CLAIMANT DETAILS (We only accept claims from the Freight Payer)
Company: / ……………………………………………………….. / Date: / ……………………………………………..Contact Person: / ……………………………………………………….. / Telephone: / ……………………………………………..
Address: / …………………………………………………….… / Email: / ……………………………………………..
…………………………………………………….… / Tax Inv/GST No: / ……………………………………………..
CLAIM DETAILS
Consignment No: / ……………………………………………………… / Despatch Date: / ……………………………………………..From/Sender: / ………………………………………………………. / To/Receiver: / ……………………………………………..
Address: / ………………………………………………………. / Address: / ……………………………………………..
……………………………………………………….. / ……………………………………………..
Contact Person: / ………………………………………………………. / Contact Person: / ……………………………………………..
Telephone: / ………………………………………………………. / Telephone: / ……………………………………………..
Type of Claim: / ( ) Damage / ( ) Loss / ( ) Other (please specify) ……………………………………………………..
Value of Goods: / The value of goods must be stated at cost $………………………………………………………………………………
Claim Description: / ……………………………………………………………………………………………………………………………
Was the damage and/or loss reported at the time of delivery?
/ ( ) Yes / ( ) No ……………………………………………..Who is holding the damaged freight? / ( ) Sender / ( ) Receiver / ( ) Other (please specify)
Other details (relevant to this claim) / ………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………………………………….………………….….
…………………………………………………………………………………………………………………………………………….………………….….
…………………………………………………………………………………………………………………………………………….………………….….
IMPORTANT NOTE: If your claim is accepted, the damaged freight becomes the legal property of Freight Lines and must be made available for collection. If the damaged freight is not provided, the claim will be declined.
CLAIMANT Declaration
I declare to the best of my knowledge, that the details provided on this form are true and correct.
Print Name: / ……………………………………………………………. / Signature: / ……………………………………………......Position: / ……………………………………………………………. / Date: / ……………………………………………......
FAX OR POST THIS FORM
AND ALL SUPPORTING DOCUMENTATION TO:
Freight Lines Ltd, PO Box 231 , Otorohanga 3940
Attn: Claims/Kayla Fax: 07 873 6514 /
Office Use Only
Claim No:Claim Entered: / Date
Claim Status: / ( ) Accepted / ( ) Declined
Claim Amt: / $
Claim Paid: / Date
Freight Lines Ltd: QA – Customer Claim Application Letter & Form: 11.10.2011 Version 6 Page 2 of 2
FREIGHT LINES\Forms\Claims\Freight Claims\Customer Claim Application Letter & Form.doc
Ó Copyright Freight Lines Ltd 2011