File a Claim

We sincerely regret that your move was not to your complete satisfaction.

Your immediate completion of this claim request form will enable us to process your claim.

The following claim form must be fully completed. Submitting an incomplete claim form will result in delays in claim processing and/or claim denials. Please be as thorough as possible and list any damaged items separately where requested below.

Which Office or Location Did You Use?*
Date of Claim*
MM slash DD slash YYYY
Name of Claimant*
First Last
Contact Information
Current Address*
Street Address Address Line 2 City State ZIP Code
Address You Moved FROM*
Street Address Address Line 2 City State ZIP Code
Primary Phone Number*
Secondary Phone Number
Email*
Loss or Damage Discovery
Loss or Damage Discovery
Loss / Damage Discovered By:*
Date of Loss / Damage Discovery*
MM slash DD slash YYYY
Moving Date*
MM slash DD slash YYYY
How Damage Occurred*
Note
If the claim is for breakage to items packed in containers, please provide the following information. Please be advised that we are not responsible for goods that were packed by the shipper and not packed, unpacked, and inspected by our company.
Total Paid to Fox Moving For Services: ($)
Number*
Detailed Statement Showing How Amount Claimed is Determined
Below, you must list each item claimed for damages. Use the + to add an additional line and complete each field as requested. One item per line and ALL information must be provided including a weight of item claimed and current value. Any fields with any inappropriate information may lead to a need to resubmit your claim.

List*
List Number, Description of Items, Nature/Extent of Damage or Loss. ETC Weight Date Aquired Original Cost Value at Time of Loss or Damage Amount Now Claimed

Supporting Documents – File Uploads

Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, xls, Max. file size: 1 MB.

Images, Documents Supporting Value of Items, Estimates of Damage, ETC.
Section Break
FALSE OR FRAUDULENT CLAIMS
Any person who knowingly and with intent to defraud any insurance company or person, files a statement of claim what contains any materially false information, or conceals for the purpose of misleading information concerning any factual material is there to committing a fraudulent insurance act, which is a crime.
Signature of Agreement
Name*
First Last
Date*
MM slash DD slash YYYY
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File a Claim

We sincerely regret that your move was not to your complete satisfaction.

Contact Information

Loss or Damage Discovery

Note

Detailed Statement Showing How Amount Claimed is Determined

Section Break

FALSE OR FRAUDULENT CLAIMS

Signature of Agreement

List Number, Description of Items, Nature/Extent of Damage or Loss. ETC	Weight	Date Aquired	Original Cost	Value at Time of Loss or Damage	Amount Now Claimed