Online claim for your relocation

For your convenience, and to better expedite the claim process, you may submit your claim online. Please complete all of the required fields.

If you moved from one state to another state, you must submit your claim form with Mayflower at https://www.mayflower.com/claims.

Customer Information
Customer Name *
Customer Name
Customer Phone
Customer Phone
Customer New Address
New Address
New Address
Delivery Date
Delivery Date
Customer Old Address
Old Address
Old Address
Pickup Date
Pickup Date
Details
Was shipment in a warehouse? *
Did employer pay for move? *
What was the declared value protection?
Are you the owner of the goods in question? *
Item #1
Carton Damaged?
Item #2
Carton Damaged?
Item #3
Carton Damaged?
Item #4
Carton Damaged?
Item #5
Carton Damaged?
Item #6
Carton Damaged?
Item #7
Carton Damaged?
Item #8
Carton Damaged?
Item #9
Carton Damaged?
Item #10
Carton Damaged?
Complete & Submit
I am the owner of the property described. I did not cause or contribute to the damage set forth herein. All statements made in this statement of claim and any attached documents are true and correct to the best of my knowledge and belief, and constitute my complete and entire claim. No material information has been withheld. DOT regulations require that any claim for loss, damage or delay must be submitted in writing by claimant and received by carrier within 30 days from date of delivery. See general instructions below this form for additional information.

General Instructions:

  • Please retain the damaged articles, including shipping cartons. These items must be available for inspection.
  • The time limit for filing a claim is 30 days from date of delivery or conversion to permanent storage. The 30-day claim filing period does not apply to government, military and some national account contracts. Contact your booking agent, transportation management office or move coordinator for specific claim filing information.
  • Please have shipping documents available at time of inspection.
  • Transportation charges must be paid prior to claim settlement.

Helpful Tips:

  • The ORDER FOR SERVICE NUMBER must be referenced on the claim form and any subsequent correspondence or inquiries. If not already entered on the claim form, this number can be found at the top right hand corner of the Bill of Lading. This number also appears on the top right hand corner of the Order for Service.
  • Complete top portion of form thoroughly. Include ZIP codes with addresses and area codes with telephone number. Please give us the phone numbers where you can be reached during normal business hours.
  • Complete all columns for articles claimed:
    • Not providing Inventory Numbers may delay the processing of your claim.
    • Give a brief description of article claimed including make and model number if applicable (COFFEE TABLE, TV-XYZ, MODEL 123).
    • Describe the extent, location and nature of damage (SCRATCH TOP RIGHT EDGE or LEFT REAR LEG BROKEN).
    • Indicate the article's replacement cost today for same or similar articles.
    • Enter the amount you are claiming in settlement. The CLAIM FORM is not complete without this amount.
    • If the claimed item was packed, please indicate whether the carton was damaged by marking YES or NO in the appropriate column. This information is important since we allocate responsibility to the party responsible for the reported damage.
  • Be sure all unpacking has been accomplished, and all items checked, before submitting claim.
  • Do not have any items repaired unless we advise you to do so.

Minimum Filing Requirements

Federal regulations establish the minimum filing requirements as a "communication in writing from a claimant filed with a proper carrier within the time limits specified in the bill of lading or contract of carriage for transportation, and (i) containing facts sufficient to identify the baggage or shipment (or shipments) of property involved, (ii) asserting liability for alleged loss, damage, injury or delay, and (iii) making a claim for the payment of a specified or determinable amount of money, shall be considered as sufficient compliance with the provisions for filing claims embraced in the bill of lading or other contract of carriage."