Claims Questions About Valuation? Claim Of DamagePlease enable JavaScript in your browser to complete this form.Company Message - Ramsey Legacy Moving strives to have no damages during a move or delivery. We have an excellent track record of this and we are here to help if an accident did occur during a recent move or delivery. Please fill out the following form to give us an accurate account of what happened: Client's InformationCustomer Name On Delivery/Move *FirstMiddleLastPhone *Email *Mailing Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhysical Address Same As Above? *YesNoPhysical AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeMethod Of Contact *TextEmailPhonePower Of AttorneyWould You Like To Use A Power Of Attorney?NoYesPower Of Attorney Relationship To Client?Significant PersonOwner Of GoodsLawyerPower Of Attorney's First Middle Last Name? *FirstMiddleLastPhoneEmailMailing AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDetails Of ClaimDate / Time Of Service *DateTimeType Of Service *Pickup/Delivery(Household Goods) MoveFirst Claim Of Damage (Item - Damaged Area - Cause) *Upload Any Pictures Of Claim * Click or drag files to this area to upload. You can upload up to 5 files. Do You Have Additional Claims To Report *One MoreTwo MoreMultiple MoreSecond Claim Of Damage (Item - Damaged Area - Cause)Upload Any Pictures Of Claim * Click or drag files to this area to upload. You can upload up to 5 files. Third Claim Of Damage (Item - Damaged Area - Cause)Upload Any Pictures Of Claim * Click or drag files to this area to upload. You can upload up to 5 files. Multiple Claims Of Damage - Please Separate Each ItemUpload Any Pictures Of Claims * Click or drag files to this area to upload. You can upload up to 40 files. Client To SignI understand and agree to the following: -I will pay in full for services Ramsey Legacy rendered before any claim is to be processed. -I understand the owner (Dustin Ramsey) is the only person that can discuss any claims of damage with me the client. Any conversation with a member of our staff outside of communication with the owner is hearsay and will not be used as a formal record. -I will submit in full any claims of damaged caused by Ramsey Legacy only once. Failure to completely inform Ramsey Legacy of all claims of damage on the first claim of damage may significantly lengthen the time of opening up an additional claim of damage at a later point. -I understand I have 9 months (from the date of service) to open a claim for damage with Ramsey Legacy. Any claim opened after 9 months (from the date of service) does not have to be reviewed or responded to by Ramsey Legacy and is considered a statute of limitation in the matter. -I understand the information provided to Ramsey Legacy can be used in any legal/insurance matters. I agree to share any information provided in this form with Ramsey Legacy and any party they seem fit to include. -I understand this form does not mean Ramsey Legacy is at fault for any of the information provided by the client. This form is a formal request to review damage that might have been caused by a member of Ramsey Legacy staff during a recent service. -I understand the maximum amount of compensation for my move/delivery will be decided by the valuation established before the service was to be performed. -I understand any liability release signed at the time of service can be used as a formal document acknowledging conditions and a release of our company for any legal claims of damage. -I understand my delivery or moving agreement signed with Ramsey Legacy will be used to handle any claim of damage caused by our company and that I agreed to these terms prior to the service to be performed. *FirstMiddleLastSubmit Share this:TwitterFacebookLike this:Like Loading...
