Damages Claim Form

Job Number:

Postal Address:

Contact First Name:

Contact Surname:

Contact Number:


Date of loss/ damage:

Goods moved from:

Goods moved to:

When was loss/ damage first discovered?

Please provide details of the loss/ damage incident?

Were goods professionally packed?
 Yes No
Were details of loss/ damage noted at time of delivery?
 Yes No
Have you notified carrier of loss/ damage?
 Yes No

Description of items to be claimed Details of loss/damage Can the item be repaired? Amount claimed (AUD)
 Yes No
 Yes No
 Yes No
 Yes No
 Yes No
 Yes No
Total amount claimed

Please attach before photos:

Please attach after photos:

 I declare that to the best of my knowledge and belief the information in this form is true and correct and I have not withheld any relevant information. I understand that Insurers do not admit liability by the issue of this form.


What our client Says

" This is the third time Six Brothers Removalist has moved us in two years. We are always very happy with the removal crew, hence our loyalty to you. Keep up the good work! Many thanks. "
Cremorne – 1 Bedroom Removalist Work