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TransVantage Forms: Claim Notification
Contact Information
Name:
Company:
Phone:
Fax:
Email:
Carrier Details
Name:
Pro#:
Return/Credit#:
Date of Shipment:
*
At least one product is required starting with the first line item and must include all fields.
Prod Code
Product Description
QTY
Weight
Billed
Dis.
Item Net
1.
2.
3.
4.
5.
6.
7.
Claim Total Net of Discounts
Refused
Accepted
Visible DMG
Hidden DMG
Shortage
Loss
Note: All Hidden damages must be reported to the carrier within 48 hours of delivery either by the customer or the Claims Department.
Location of Damaged Product or Equipment
Customer Address:
Carrier Location:
Shipping Warehouse:
Delivery Point Contact Information
Contact:
Phone:
Fax: