Fillable Odfl Dastandard Form For Presentation Of Loss And Damage Claim Form printable pdf download

Odfl Dastandard Form For Presentation Of Loss And Damage Claim Form

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Standard Form for Presentation of Loss and Damage Claim

Mail

Old Dominion Freight Line, Inc

EMAIL CLAIMS TO:

Date: _______________________

To:

500 Old Dominion Way

Fax: 336-822-5494 or 336-822-5010

Thomasville, NC 27360

This claim for $______________ is made against your company for:

 Shortage

 Noted Damage

 Concealed Damage

 Theft

 Other

Shipper: _____________________________

Consignee: ______________________________

Date of Bill of Lading: ___________________

Date of Delivery: __________________________

Pro or Waybill Number: __________________

Claimant's Claim Number: __________________

(if applicable)

Detailed Statement Showing How Amount of Claim is Determined

(Number and description of articles, nature and extent of loss or damage, invoice price of articles,

amount of claim, etc. ALL DISCOUNT and ALLOWANCES MUST BE SHOWN)

TOTAL AMOUNT CLAIMED:

The following documents are submitted in support of this claim (if applicable):

 Original Bill of Lading

 Original invoice of goods (REQUIRED) and repair

or replacement invoice(s), if applicable

 Original Delivery Receipt

 Other supporting documents

Company Name: ___________________________ Remit to (if different): __________________________

Attention: _________________________________Attention: _____________________________________

Mailing Address: ___________________________ Mailing Address: _______________________________

City/State/ZIP: _____________________________City/State/ZIP: _________________________________

Telephone Number: _________________________Signature: ____________________________________

FAX Number: ______________________________Email: _______________________________________

Please DO NOT fax photos! Please send your claim to the email address at the top of this form.

Photos may be

emailed or mailed to the address above. Any questions, please contact the Claims Department at 800-825-6636

or Corporate Customer Service at 800-235-5569

You have nine (9) months from the date of delivery to file a claim. Old Dominion has 30 days to acknowledge a

claim in writing and 120 days to process. Please be patient during this time.

By submitting this claim, you acknowledge that the subject shipment above is governed by the terms and

conditions of Old Dominion Freight Line, Inc.'s applicable tariff(s), available upon request and at

Odfl Dastandard Form For Presentation Of Loss And Damage Claim Form

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