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Get USPS Claim Form 2006

FOR PARCEL INSURANCE PLAN POLICYHOLDERS USE ONLY US POSTAL SERVICE USPS CLAIM FORM For Lost or Damaged Packages - Revised 08/06 INSTRUCTIONS Complete and mail this claim form no earlier than 30 DAYS and no later than 180 DAYS from shipment date. Attach a copy of your original invoice to the consignee. If at all possible attach A. A copy of the USPS tracer form* The USPS reply is not needed* We advise filing a tracer for all lost USPS packages whether or not you send a copy to us. B. A copy of the check from USPS if you insured part of the value with USPS* D. For computerized shipping system users only - Copy of shipping system daily report detailing amount of claim insured with PIP. 5. Mail to PARCEL INSURANCE PLAN P. O. BOX 66708 ST. LOUIS MO 63166-6708. Or FAX to 314-692-7598 include all requested documentation CLAIM PAYMENT FORM Insured s Name Policy Address Shipped From Consignee s Name Invoice Date Mailed Loss Damage Shortage Number of Packages You or consignee should hold damaged items in the event they are requested during claim processing* FAILURE TO RETAIN DAMAGED PROPERTY COULD AFFECT FINAL SETTLEMENT OF THE CLAIM. Description of Items Amount of claim Invoice or repair cost of contents lost or damaged excluding shipping fees Amount cannot exceed value declared upon shipment Less amount paid by USPS if any Less salvage value of damaged goods Balance to be paid by PIP The balance of your unpaid claim will be forwarded to you promptly upon receipt of this completed claim form and items noted in 2 3 and 4 of the above instructions. I certify that the above statements are correct. Signature Send check to attention of Telephone Ext. Email Address Fax No* Date FOR PIP USE ONLY AMOUNT DATE BY Warning Any fraudulent claims will make the shipper and/or consignee liable for prosecution for mail fraud under the Federal Criminal Code. If we have not responded to your claim within 3 weeks of filing you may check the status of your claim at www. Attach a copy of your original invoice to the consignee. If at all possible attach A. A copy of the USPS tracer form* The USPS reply is not needed* We advise filing a tracer for all lost USPS packages whether or not you send a copy to us. B. A copy of the check from USPS if you insured part of the value with USPS* D. For computerized shipping system users only - Copy of shipping system daily report detailing amount of claim insured with PIP. B. A copy of the check from USPS if you insured part of the value with USPS* D. For computerized shipping system users only - Copy of shipping system daily report detailing amount of claim insured with PIP. 5. Mail to PARCEL INSURANCE PLAN P. O. BOX 66708 ST. LOUIS MO 63166-6708. Or FAX to 314-692-7598 include all requested documentation CLAIM PAYMENT FORM Insured s Name Policy Address Shipped From Consignee s Name Invoice Date Mailed Loss Damage Shortage Number of Packages You or consignee should hold damaged items in the event they are requested during claim processing* FAILURE TO RETAIN DAMAGED PROPERTY COULD AFFECT FINAL SETTLEMENT OF THE CLAIM. .

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