Move Date
First/Last Name
The name of the contractual customer
Your answer
Move Number
Move # can be found on your the contract you signed to confirm move details
Your answer
Did you hire Moving Proz LLC for packing services?
Did you pack the boxes or did we?
Where did the damage occur
Damaged Item
ex. Dresser, kitchen table, Grandfather Clock etc.
Your answer
Manufacturer/ Brand/ Model Number(s)
Your answer
Explanation of Damage(s)
Your answer
What was the Item made of
is the item repairable?
Explanation of incident
be as specific as possible (names,suggestions, warnings, accidental/intentional, negligence, reactions)
Your answer
Were you present during the incident and if not where where you when it happened?
Your answer
Upload Pictures and Receipts
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