Damaged Shipment Request DAMAGED SHIPMENT REQUEST FORM Customer Name*Requested By*Delivery Date* Date Format: MM slash DD slash YYYY Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*PO Number*Order/Invoice NumberItem Number*Quantity*Serial NumberCheck All That Apply* Seal Broken Open Box Apparent Damage Concealed Damage Refused Shipment Details*Signed for Free and ClearPartial Shipment RefusedEntire Shipment RefusedException Number from DriverCommentsPhoto Details Required Must include photos with details of packaging to include broken seals and/or open boxes. Must include photos from all sides of box and item enclosed.Files Drop files here or Accepted file types: jpg, png, pdf, jpeg.
