Stuller Inc. New Shipping Claim

Please complete all fields with detailed information and check for accuracy.

Hidden

Insured's Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Hidden

Policy Begin Date

Hidden

Policy End Date

Hidden

Deductible

Submitter Contact Information

Name(Required)

First Last

Email(Required)

Phone(Required)

Loss Details

Stuller Customer(Required)

Stuller Invoice No. / Reference(Required)

Stuller Invoice Date(Required)

In UK Format

Type of Loss(Required)

Date of Loss(Required)

In UK Format

Type of Loss - Other

Brief Description of Package Contents(Required)

What happened to the shipment?(Required)

Package last scanned in which city?

Package last scanned on what date?

UK Format

How were the contents secured?(Required)

Insured Value(Required)

Loss Amount(Required)

Claim Amount(Required)

Policy Limit for This Type of Shipment(Required)

Policy Limits are as follows:
USPS Registered Mail is $100,000
FedEx/UPS/Similar Ground is $100,000
FedEx/UPS/Similar Express is $100,000
Outside of USA is $100,000

Shipment Details

Shipping Company(Required)

Shipping Service(Required)

Tracking Number(Required)

Dispatch Date(Required)

UK Format

Expected Delivery Date(Required)

UK Format

Was shipment insured with the shipping company?(Required)

Yes

Has the shipping company reimbursed you for the loss?(Required)

Yes

How much did the shipping company pay?

Shipper Details

Who actually dispatched the shipment?

Shipper Name(Required)

From which city?(Required)

From which state?(Required)

Full State Name

Intended Recipient Details

Intended Recipient Name(Required)

To which city?(Required)

To Which State?(Required)

Full State Name

Shipping Label Details

Shipper Name / Company(Required)

Recipient Name / Company(Required)

Shipper Address(Required)

Street Address Address Line 2 City State ZIP Code

Recipient Address(Required)

Street Address Address Line 2 City State ZIP Code

Additional Information

Upload Claim Documents(Required)

Drop files here or

Max. file size: 32 MB.

Stuller Customer Invoice
Stuller Security Notes
Invoice(s) for Package Contents
Shipping Label
Photos of Shipment (if damaged/tampering)
Shipping Carrier Claim Form
Correspondence with Carrier
Police Report (if applicable)
GIA Certificate, Rolex Serial Number Details, etc.
Other Relevant Documentation

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