Claim Form Review

Claim Information

First Name:
Last Name:
E-mail address:
Origin Address:
Origin City:
Origin State:
Origin Zip Code:
Destination Address:
Destination City:
Destination State:
Destination Zip Code:
Home Telephone number:
Registration Number:
Load Date:
Storage Agent:
Declared value:
Employer:
First Name:
Last Name:
Email Address:
Origin Address:
Origin City:
Origin State/Providence:
Origin Zip Code:
-
Destination Address:
Destination City:
Destination State/Providence:
Destination Zip:
-
Phone Number w/ Area code:
Registration Number:
Move Date/Load Date:
Storage Agent:
Declared Value:
Employer (if employer paid for move):


Claim Items
Please, add at least a Claim Item

Add Claim Item

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Inventory Item Number:
Description of Article:
Description of Damage:
Weight of Article:
Date of Purchase:
Purchased From:
Original Purchase Price:
Amount Claimed:



Add items to your Claim

Inventory Item Number:
Description of Article:
Description of Damage:
Weight of Article:
Date of Purchase:
Purchased From:
Original Purchase Price:
Amount Claimed:

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Store Your Things Self Storage

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740 Frontenac Road - Suite 200  Naperville, IL  60563
All Rights Reserved.  USDOT 070851
 
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