Claims Form

We are sorry you have found it necessary to report a claim. Jason Taylor Moving and Storage attempts to settle all claims in an equitable and timely manner. We appreciate your cooperation in filling out the form. Upon receipt of the form, a file will be established and assigned to an adjuster. You should receive a letter, call or an e-mail, within 3 weeks of receipt of the claim form in acknowledgment. 

General Instructions:

  1. Please retain the damaged articles, including shipping cartons. These items must be available for inspection.
  2. Complete the 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.
  3. 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 the 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.
  4. If more than one item is being claimed, click the add another item button at the bottom right of the page.
  5. Be sure all unpacking has been accomplished, and all items checked, before submitting claim.
  6. Do not have any items repaired unless we advise you to do so.


               Please note that we allow only one claim form to be submitted per move.


New Address

New Address(Required)
MM slash DD slash YYYY

Old Address

Old Address(Required)
MM slash DD slash YYYY
Inventory Number Amount Claimed Actions
Enter up to 10 items