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WHITE LION CLAIM FORM

Send your claim via certified mail to: SunCoast Trucking Compliance 17067 80th Street N. Loxahatchee, FL 33470
 
IMPORTANT: A local move claim must be filed within 90-days after the deliver of your shipment.  Please attach a copy of your documents to expedite the claim
 

CLAIMANT’S NAME

CLAIMANT’S  CURRENT HOME ADDRESS
       

PICK UP DATE

 DELIVERY DATE SHIPMENT ORIGIN ADDRESS
           
HOME PHONE CELL PHONE DELIVERY ADDRESS
           
 
INVOICE #
DESCRIPTION OF ARTICLE
DESCRIPTION OF DAMAGE/LOSS
WEIGHT OF ITEM
DATE OF PURCHASE
PURCHASE PRICE
AMOUNT CLAIMED
--- --- --- NO ITEMS --- --- --- --- ---
ITEMS = 0
   
PLEASE NOTE:
  • No settlement can be made until all freight bills have been paid.
  • The carrier reserves the right to inspect all damage prior to repair.  Do not discard any packing materials or make any repairs until damage has been ve rified. Damage that cannot be verified will not be covered.
  • Please fill in all information requested. Failure to do so could slow down the time processing of your claim.
      By making this claim, the undersigned hereby warrants that he/she is authorized to submit this claim on behalf of the shipper/consignee, and hereby consents to the disclosure of the information provided herein and that all other information about the claim to the National Household Goods Claim Registry (NHGCR) and to any participating members of the NHGCR.
      I/we, the owner(s) of the property described above and on attached pages, did not cause or contribute to the damage/loss set forth herein, hereby certify that the above information is true and accurate to the best of my/our knowledge and belief, and constitutes my complete and entire claim.  No material has been withheld.

Toll Free 800-944-8354
Local 561-997-2400
sales@whitelion.com


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Location:
1040 Holland Drive
Boca Raton, Florida 33487
Toll Free 800-944-8354
Local 561-997-2400
ICC# MC 298528 || PBC #MV62 || USDOT# 624036
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