Online SLT Claim Form
(* Fields are mandatory)
Date 5/19/2012
Customer Claim No. 1006
Name of firm by whom the claim is presented*
Name of Claimant or individual filing claim*
Claimant's Reference #*
Attention*

 

Carrier Details Claimant Details
Name* Street*
Street* City*
City* State*
State* Zip*
Zip* Email
Phone Phone

 

This claim of $ *  is made against the carrier named above by (claimant name) * for * in connection with the following described shipment.
Shipped from (City, Town or Station) * To (City, Town or Station) *

 

Bill of Lading issued by*
Date of Bill of Lading*
Final Destination*
Paid Freight Bill (Pro) Number*

 

Consignor (shipper) Consignee (whom shipped to)
Name* Name*
Street* Street*
City* City*
State* State*

 

Detailed statement showing how amount claimed is determined (number and description of articles, nature and extent of loss or damage, invoice price of articles, amount of claim, etc.)*



 

The following document(s) must be submitted in support of the claim before it will be processed. These documents can be submitted via fax OR the US Postal Service.
1. Copy of the bill of lading, if not previously surrendered to carrier.
2. Copy of the paid freight ("expense") bill.
3. Certified copy of the invoice.
4. Other particulars obtainable in proof of loss or damage claimed.
5. Any other document, or information you feel is needed.
The mailing address is:
Straight Line Transportation Inc.
Claims Dept.
440 Andbro Drive
Pitman NJ 08071
The fax number is 856-582-7450.

 

Through submission of this online claim form, I attest that the foregoing statement of facts is hereby certified as correct.