Oversized Machinery Cargo Damage Claim Form
Claimant Information
Company Name
Contact Person
Phone Number
Email Address
Address
Cargo & Shipment Details
Machinery Description
Serial/ID Number
Origin
Destination
Shipment Date
Arrival Date
Carrier/Transport Company
Bill of Lading / Reference Number
Damage Details
Date of Damage
Location of Damage
Description of Damage
Suspected Cause
Estimated Loss/Value (Currency/Amount)
Evidence/Photos (List file names or describe attachments)
Additional Information
Immediate Actions Taken
Other Relevant Information
Declaration
I hereby declare that the above information is true and correct.
Name of Authorized Signatory
Date