Freight Bill Number Your Claim Number Service Date (mm/dd/yyyy)

CLAIMANT INFORMATION

Company:
Contact Person:
Street Address:
City:
State: Zip Code:
Phone:
Fax:
Email:

STATEMENT OF CLAIM

Type: 
Total Amount Claimed $: 

Explain in detail how you determined the claim amount. List the number and description of the goods, the nature and extent of loss or damage, the invoice cost, and other pertinent details.

SUPPORTING DOCUMENTS

Indicate the documents you will send with the claim. The original vendor invoice is required. The others are optional.

PLEASE UPLOAD SUPPORTING DOCUMENTS:
           

Please email supporting documentation to: claimsdept@freightforce.com
or mail to:
P.O. BOX 1058 La Mirada, CA. 90637-1058

Freight Force, Inc.
14445 Alondra Blvd.
La Mirada, CA 90638