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Apr. 13, 2018 3FBEUIFGPMMPXJOH'"2TGPSBOTXFSTPOUIFDMBJNSFTPMVUJPOQSPDFTT

Who can file a claim? When should I file my claim?


The sender, the recipient or a third party can file the claim. $MBJNTGPS'FE&Y¥$PMMFDUPO%FMJWFSZ $0%
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How do I file a claim? $MBJNTGPSDPODFBMFEMPTT WJTJCMFPSDPODFBMFEEBNBHF BOE
Follow the three easy steps listed below to file your claim. EFMBZNVTUCFSFQPSUFEXJUIJODBMFOEBSEBZTBOEBMM
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Step 1: Choose one of the following options:
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fedex.com/us/claimsonline. UP'FE&YGPSTIJQNFOU"MMDMBJNTXJMMCFSFTPMWFECBTFEPOUIF
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 t$PNQMFUFBDMBJNGPSNBOEFNBJM GBYPSNBJMJU How long will the claim resolution process take?
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Step 2: (BUIFSUIFGPMMPXJOHEPDVNFOUBUJPO documentation, unless additional time for research is needed.

 t1IPUPDPQZPG'FE&YBJSXBZCJMM 'FE&Y4IJQ What should I do with the merchandise and


Manager®QSJOUPVU 'FE&Y(SPVOE1JDL6Q shipment packaging?
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screen if online order with proof of payment,
JUFNJ[FESFQBJSJOWPJDFPSTUBUFNFOUPGOPOSFQBJS  Where can I find specific information about the claim
BQQSBJTBMT FYQFOTFTUBUFNFOU PSBOZPUIFS resolution process?
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 For more detailed information, including time limits for
specific claim types, go to fedex.com or refer to the current
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Can I get updates on the status of my claim?
Step 3: &NBJM GBYPSNBJMUIFDPNQMFUFEDMBJNGPSNXJUIUIF *GZPVVTFPVSPOMJOFGJMJOHPQUJPOBUfedex.com/us/claimsonline,
supporting documentation to: ZPVDBODIPPTFUPSFDFJWFQFSJPEJDFNBJMVQEBUFTPOUIFTUBUVT
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Cargo Claims Dept.
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1/09
Claim Form
For lost or damaged U.S. or international shipments

Sender or Shipper’s Name / Contact FDX EXP/OAKLAND- EMERYVILL Recipient’s or Consignee’s Name / Contact ROB WORTH
Company Company
Address 1600 63RD ST Address 87 MAIN ST
City EMERYVILLE State / Province CA City CANTON State / Province NC
Country US ZIP / Postal Code 946082033 Country US ZIP / Postal Code 28716
Phone 5105478503 Fax Phone Fax
E-Mail E-Mail

Tracking or Freight Bill 780399663398

Numbers "EEJUJPOBMUSBDLJOHOVNCFSTGPSUIJTDMBJNSFRVFTUBMMPXFE NVTUIBWFTBNFTFOEFS SFDJQJFOU BOETIJQEBUF

Shipment Information Ship date 04/05/2018 No. of packages 1 Weight 63.40 L

! Loss FedEx control number


! Complete (NOTE: Call 1.800.GoFedEx 1.800.463.3339 to obtain a FedEx Express control number or a FedEx Ground damaged call tag confirmation number.)

! Partial Qty of Packages Item # Item Description Claimed Amount

1 4309 Apple Power Macintosh G3 233 $350.00


! Damaged
Please retain all packaging and merchandise
until your claim is resolved.

Contents of shipment Vintage computer


! C.O.D.
For FedEx Express® and FedEx Ground® Only Describe damage to outer packaging
No outer damage visible.

Describe inner packaging


Packed professionally by FedEx ship center
in Berkeley with padding.

Describe damage to contents Computer was cracked in several places, and no


longer works. Damage to internal components
caused computer to become inoperable.

Declared value
(The value declared on the Declared value for customs
shipment when tendered to FedEx) $ (International shipments only) $
Merchandise value
(Original purchase value and/or cost to repair) $ 350
FedEx pack & ship fee $ 31.67 Freight charge $ Total claim / C.O.D. amount $
Customer remarks

If your claim is filed for damage, and mitigation through repair or allowance is not possible, please explain why and provide contact information for salvage pickup.
Salvage Salvage should be held until investigation of the claim is complete.

Salvage Contact Phone Fax

Claimant Information ! I accept that the foregoing statement of facts is hereby certified as correct. Date
Signature (for fax or mail) Internal Reference No.
Claimant’s Name (please print)
Claimant’s Address Phone
City State / Province
Country ZIP / Postal Code
E-Mail Fax

E-mail, Fax or Mail Please return the completed form and required Proof of Value documentation (invoice and/or receipt) to:
E-mail: file.claim@fedex.com | Fax 1.877.229.4766 | FedEx Cargo Claims Dept. P.O. Box 256 Pittsburgh, PA 15230

SUBMIT
31581PL 1/09

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