Dd Form 1844 - List Of Property And Claims Analysis Chart

ADVERTISEMENT

C I O H A N D B O O K
3 January 2003
LIST OF PROPERTY AND CLAIMS ANALYSIS CHART
DD FORM 1844
ITEM NO.
CLAIMANT IS RESPONSIBLE FOR COMPLETING ITEMS 1 THROUGH 13
1.
NAME OF CLAIMANT
ENTER LAST NAME, FIRST NAME, MIDDLE INITIAL
2.
CLAIMANT'S
INSURANCE
COMPANY
A. NAME OF THE
IF CLAIMANT HAS PRIVATE INSURANCE, THE NAME OF THE INSURANCE COMPANY IS
INSURANCE
ENTERED (I.E., USAA, ARMED FORCES CO-OP, STATE FARM, ETC). NOTE: A CLAIM MUST BE
COMPANY
FILED WITH THE PRIVATE INSURER PRIOR TO, OR CONCURRENTLY WITH THE
GOVERNMENT CLAIM.
B. POLICY NUMBER
POLICY NUMBER OF THE APPLICABLE INSURANCE POLICY
3.
DATE OF PICKUP
DATE THE PROPERTY WAS PICKED UP AT SHIPMENT ORIGIN FROM THE CLAIMANT OR THE
CLAIMANT'S AGENT
4.
DATE OF DELIVERY
DATE THE PROPERTY WAS DELIVERED TO THE CLAIMANT OR THE CLAIMANT'S AGENT
5.
LINE NUMBER
THIS SHOULD REFLECT EACH LINE ITEM CLAIMED, NUMBERING THE ITEMS IN SEQUENCE
(I.E., 1, 2, ETC.)
6.
QUANTITY
NUMBER OF ITEMS CLAIMED (I.E., 2 END TABLES, 1 COFFEE TABLE, ETC.)
7.
DAMAGED OR LOST
STATE IN AS MUCH DETAIL AS POSSIBLE THE BRAND NAME, MODEL, SIZE, FINISH, TYPE,
ITEMS
STYLE, AND YEAR OF MANUFACTURER, AS APPROPRIATE. WHEN AN ITEM IS MISSING,
STATE "MISSING" AND WHERE DAMAGED IS CLAIMED, GIVE A DETAILED DESCRIPTION OF
THE DAMAGE. NOTE: ESTIMATE FEES, AND/OR PICKUP AND DELIVERY FEES TO AND FROM
THE REPAIR SHOP, ARE TO BE LISTED AS SEPARATE LINE ITEMS.
8. INVENTORY NUMBER
ENTER INVENTORY NUMBER AS SHOWN ON THE PICK-UP (ORIGIN) INVENTORY. WHERE
ITEMS ARE PACKED IN A CARTON, ENTER THE CARTON INVENTORY NUMBER, EVEN WHERE
ONLY PART OF THE CONTENTS OF THE CARTON ARE CLAIMED. EACH ITEM LISTED MUST
HAVE AN INVENTORY NUMBER. DO NOT ENTER UNKNOWN FOR THE INVENTORY NUMBER
8.
ORIGINAL COST
PURCHASE PRICE OF THE ITEM MUST BE INDICATED; WHERE MORE THAN ONE ITEM IS ON
THE LINE, ENTER TOTAL PURCHASE PRICE. IF ITEM IS A GIFT, THE VALUE OF THE ITEM AT
THE TIME RECEIVED MUST BE STATED
9.
MM/YY YY
ENTER THE MONTH AND YEAR PURCHASED. IF ITEM IS A GIFT, ENTER THE MONTH AND
PURCHASED
YEAR PURCHASED, IF UNKNOWN, ENTER THE MONTH AND YEAR RECEIVED.
10. AMOUNT CLAIMED
A. REPAIR COST
STATE THE COST OF THE REPAIR FOR EACH SEPARATE LINE ITEM. IF AN ESTIMATE OF
REPAIR OR REPAIR BILL INCLUDES MORE THAN ONE ITEM, THE ESTIMATE OR BILL MUST BE
ITEMIZED TO REFLECT ACTUAL COST FOR EACH AND THAT AMOUNT IS ENTERED. IF
REPAIR ESTIMATE OR BILL COVERS REPAIR OF BOTH OLD OR NEW DAMAGE, IT MUST BE
ITEMIZED TO SHOW A SEPARATE COST FOR EACH ON LETTERHEAD PAPER (SHOWING
NAME, ADDRESS, AND PHONE NUMBER OF REPAIR FIRM) AND SIGNED BY THE REPAIRMAN.
B. REPLACEMENT
ENTER THE PRICE FOR REPLACEMENT OF MISSING OR UNREPAIRABLE ITEMS. AMOUNT
COST
MUST BE FOR A NEW ITEM IDENTICAL OR SUBSTANTIALLY SIMILAR TO THE MISSING OR
UNREPAIRABLE ITEM. IF THE REPLACEMENT COST EXCEEDS THE PURCHASE PRICE,
WRITTEN REPLACEMENT COST FROM A REPUTABLE FIRM MUST BE SUBMITTED FOR THE
HIGHER REPLACEMENT COST TO BE CONSIDERED.
11. REMARKS
THIS SPACE IS FOR CLAIMANT TO PROVIDE ANY ADDITIONAL INFORMATION REGARDING
THE CLAIM ITEMS
12. TOTAL AMOUNT
ON THE LAST PAGE OF CLAIMANT'S DD FORM 1844, ENTER THE TOTAL AMOUNT ON THE
CLAIMED
CLAIM. THIS AMOUNT, IN TURN, MUST BE ENTERED ON THE DD FORM 1842, BLOCK 9.
NUMBER EACH PAGE ON THE DD FORM 1844 SHOWING THE TOTAL NUMBER OF PAGES
PAGE ___ OF ___ PAGES
SUBMITTED (I.E., "PAGE 1 OF 3 PAGES, PAGE 2 OF 3 PAGES, PAGE 3 OF 3 PAGES"). THIS
ACTION FROM THE CLAIMANT WILL HELP PREVENT THE CLAIM FROM BEING ADJUDICATED
WITH MISSING PAGES.
DD FORM 1844.doc
17

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Business
Go
Page of 2