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Comments:
1 - All claims must have an attached copy of the original shipping invoice and an invoice billing ADL.
2 - All claims must be filed within 10 business days of the date of shipment. Any claims filed after this grace period will be
denied and returned to the shipper.
3 - Any claims for lost or damaged freight will be denied if a signature is obtained at the time of delivery.
4 - ADL will not be responsible for any checks provided by a customer unless ADL is specifically asked to collect cash at the
time of delivery. If authorization is given by an employee of the shipping location, ADL will not be responsible.
5 - There should be only one claim form per shipment.
6 - ADL will not be responsible for any unsecure/unprotected stops.
IE: Any stops that are dropped at night without a secure location or protection from the elements.
For ADL Use Only
Approved
Denied
Original Invoice #
Original Ship Date
Claim Form
(Claim#)
This number should reflect the number of the invoice billing ADL.
Directions
Claim Details
LOSS DAMAGE
Please Check One
This Claim is submitted for:
Please provide full address, city, st, ZIP, and phone number. Please provide full address, city, st, ZIP, and phone number.
(part #'s, description of the parts being claimed, amount claimed)
Part # Description Amount Claimed
Remarks and Description from Claimant:
Total Amount Claimed
Lost Parts or Lost/Uncollected COD's
Damaged Parts
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The foregoing statement of facts is hereby certified as correct:
(Signature of claimant)
Missing Freight
Missing Return Freight
Water Damage
Visible Shipping Damage
Uncollected COD
Remarks and Description from Claimant:
Concealed Damage