For AVL Use ONLY Did Your Employer Pay for the Move (select one) ? Inventory Number Zip Article Description Agent / Storage Company Name, City, State No Yes; Specify Employer Name-Next Field Description of Damage or Loss Employer Name (If Employer Paid Only) Estimated Weight Age or Date Purchased Original Cost I am the owner of the property described. I did not cause or contribute to the damage set forth herein. All statements made in this statement of claim and any attached documents ar.
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How to fill out the Arpin Van Lines Form PA1-22 online
Filling out the Arpin Van Lines Form PA1-22 online can streamline your claims process and help you submit important information efficiently. This guide provides a clear, step-by-step approach to ensure you complete the form accurately.
Follow the steps to complete the Arpin Van Lines Form PA1-22 online.
- Click the ‘Get Form’ button to access the Form PA1-22 and open it for editing.
- Enter your customer name in the designated field at the top of the form.
- Fill out your old address, including street address, city, state, and zip code.
- Provide your home and office phone numbers in the respective fields.
- Specify the pickup date and delivery date as required.
- Select your chosen coverage option for full replacement value, either 'Declared Valuation' or '$.60 Per Pound'.
- Indicate whether your shipment was stored in a warehouse by selecting 'Yes' or 'No'.
- If applicable, specify your employer’s name if they paid for the move.
- Describe the damage or loss in the provided text box.
- Enter the estimated weight, age or date purchased, and original cost of the damaged items.
- Indicate whether the claim includes deductible amounts and enter the dollar value if applicable.
- Type your name in the signature area to sign the document electronically.
- After ensuring all fields are completed and accurate, save your changes, and proceed to download, print, or share the form.
Complete your documents online today for a smooth claims process.
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