MyYellow - Claims Filing Form

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Location: Online Tools > Claims Resolution > Claims Filing Form

CLAIM

*Required Fields

*Freight Bill Number

Pickup Date

MM/DD/YYYY

CLAIMANT INFORMATION

*Company Name

*Name Of Person Filing Claim

*Address

*City

*State

*Zip Code

Phone

Fax

Email Address

STATEMENT OF CLAIM

*Select one:

Shortage Visible Damage Concealed Damage Other

Your Claim Number

Your number, not ours

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 the amount of your claim. You must have at least one Description and Claim Amount.
Description	Claim Amount




*Total Amount Claimed: $

COMMENTS

SUPPORTING DOCUMENTS Check the documents you'll send with the claim. The original vendor invoice is required. The others are optional.

*Original Vendor Invoice

Copy Of Bill Of Lading	Original Repair Invoice
Copy Of Paid Freight Bill	Record Of Discounted Sale
Inspection Report	Other
Consignee Copy Of Delivery Receipt	Other
Description Of Shortage Or Damage Brochures, drawings, photographs, etc.

Note: Press this button to get a printable copy of your claim.