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Concealed Loss / Damage Report

Concealed Loss or Damage Inspection Report
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Concealed Loss / Damage Report


General Facts

Date and Time of delivery

Date inspection requested

Requested by:

Dates good opened or unpacked

Was shipment delivered to this address by our truck or picked up at the terminal by consigned?

Have goods been moved from floor to floor, or to location other than delivery site? If so explain.

Could (or should) damage have been noticed at time of delivery? ( based on your opinion as you now see container and/or goods)

Shipping container:

Container type:

Container is:

Closure method:

Are seams or edges or container split or open?

Container manufactured by:

Bursting strength per square inch:

Pack number ( very important if commodity is furniture)

Packing -Unpacking, etc

We're goods unpacked prior to inspection?

We're containers held for inspection?

How were goods packed in containers? ( nested, individually boxed, etc.)

Inner packing:

Is there any evidence that loss or damage is the result of inferior packing, interior or exterior? Explain

Prior Transportation

Are the goods in the original factory packed containers?

Does original method of sealing indicate opening of or tampering with since leaving factory?

What was the original point of shipment from factory?

Concealed Loss (only)

Was there space in container for missing goods?

If so what occupied space?

Does actual comparison check with invoice verify loss?

We're flaps glued, sealed or otherwise closed?

Was factory sealing tape intact?

Commodity Information

What is lost or damaged? ( Commodity or Product description)

How many?

Approximate weight?

Released valuation per pound

Describe exactly how, where, why and the extent of loss or damage. Please explain each in detail.

Invoice cost of article?

Can it be repaired locally?

Estimated cost of repairs?

Amount cash allowance will accept?

Recommended salvage disposition?


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Damaged item to and including parts must be held for carrier disposition

Note: This report is merely a Statement of Facts and not an Acknowledgement or Denial of Liability. It Is Not A Claim. The original must be forwarded along with other particulars called for on Standard Claim Form.

Name and signature of company representative

Name and signature of AAA Cooper Transportation Representative

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