Get Yusen Logistics

YLA Standard Form for Presentation of Loss and Damage Claims Yusen Logistics Americas Inc. YLA Claims Department 13901 Sutton Park Drive South Suite C 270 Jacksonville FL 32224 Phone 904 485-4000 or 800 532-9618 Fax 901 260-8764 E-Mail YLAClaims us. yusen-logistics. com This claim for Date Submitted Claimants Claim is made with YLA by Amount of Claim For Claimant in connection with the following described shipment Loss or Damage YLA Freight Bill Name and address of consignor Shipper Receiver Date of Bill of Lading Trailer of Intermodal Container DETAILED STATEMENT OF INCIDENT AND HOW AMOUNT WAS DETERMINED Total Amount Claimed To expedite your claim please attach the following documents docs. Although the validity of the claim has yet to be determined please note that this company is unable to issue checks without a W-9 on file. It is the responsibility of the Claimant to provide a W-9. By my signature below I hereby affirm that I am authorized to sign as an officer of the company that is the beneficial owner of this claim or that I represent the beneficial owner of the above claim and I agree to defend and hold harmless YLA from any other claimant against the above incident. Signature of Claimant Title The foregoing statement of facts is hereby certified true and correct Claimant s Name Address Payment Address for Claimant. yusen-logistics. com This claim for Date Submitted Claimants Claim is made with YLA by Amount of Claim For Claimant in connection with the following described shipment Loss or Damage YLA Freight Bill Name and address of consignor Shipper Receiver Date of Bill of Lading Trailer of Intermodal Container DETAILED STATEMENT OF INCIDENT AND HOW AMOUNT WAS DETERMINED Total Amount Claimed To expedite your claim please attach the following documents docs. Although the validity of the claim has yet to be determined please note that this company is unable to issue checks without a W-9 on file. Although the validity of the claim has yet to be determined please note that this company is unable to issue checks without a W-9 on file. It is the responsibility of the Claimant to provide a W-9. By my signature below I hereby affirm that I am authorized to sign as an officer of the company that is the beneficial owner of this claim or that I represent the beneficial owner of the above claim and I agree to defend and hold harmless YLA from any other claimant against the above incident. It is the responsibility of the Claimant to provide a W-9. By my signature below I hereby affirm that I am authorized to sign as an officer of the company that is the beneficial owner of this claim or that I represent the beneficial owner of the above claim and I agree to defend and hold harmless YLA from any other claimant against the above incident. Signature of Claimant Title The foregoing statement of facts is hereby certified true and correct Claimant s Name Address Payment Address for Claimant. yusen-logistics. com This claim for Date Submitted Claimants Claim is made with YLA by Amount of Claim For Claimant in connection with the following described shipment Loss or Damage YLA Freight Bill Name and address of consignor Shipper Receiver Date of Bill of Lading Trailer of Intermodal Container DETAILED STATEMENT OF INCIDENT AND HOW AMOUNT WAS DETERMINED Total Amount Claimed To expedite your claim please attach the following documents docs. Although the validity of the claim has yet to be determined please note that this company is unable to issue checks without a W-9 on file. It is the responsibility of the Claimant to provide a W-9. By my signature below I hereby affirm that I am authorized to sign as an officer of the company that is the beneficial owner of this claim or that I represent the beneficial owner of the above claim and I agree to defend and hold harmless YLA from any other claimant against the above incident.