Transportify – Customer Claim Notification Form

Claimant name:

truthful confirm Amount

Claimant address:

Contact Person Name

First

Last

VAT Registered:

Yes
No

Email

Is this the first written notification of the incident to us?

Yes
No (If no, please forward any correspondence that has gone out to date)

Shipment reference:

Date of dispatch:

Date of incident:

Loading address:

Unloading address:

Nature of Claim

Damaged
Shortage
Non-delivery
Lost

How were the goods packed and secured to the pallets?

Where can the damaged goods be inspected?

Total weight of the consignment (with evidence if possible):

Weight of missing or damaged goods:

Total cost price of the consignment (£):

Cost price of the missing/damaged goods (£):

Amount claimed (£):

Is there any salvage value?

Essential Supporting Documents (tick when attached)

Supplier’s invoice showing cost price (or margin evidence)
Sales invoice showing price paid by customer
Written notification of intent to claim
Photographic evidence (if damaged goods)

Note: Claims must be made within the correct window:
CMR: within 12 months
RHA (signed as damaged): within 14 days
RHA (not signed as damaged): within 7 days

File Upload

Click or drag files to this area to upload. You can upload up to 12 files.

By ticking this box, I confirm that all the information provided above is accurate and truthful to the best of my knowledge. I understand this will serve as my electronic signature for the purposes of this claim.

I agree and Confirm

Date

Print name

Signature

Clear Signature

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Transportify – Customer Claim Notification Form

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