Online claim for your relocation

For your convenience, and to better expedite the claim process, you may submit your claim online. Please complete all of the required fields.

If you moved from one state to another state, you must submit your claim form with Mayflower at https://www.mayflower.com/claims.

Tip: You can save your progress and return later. Scroll to the bottom for the save button!

Customer Information

Name(Required)

Customer New Address

New Address(Required)
Delivery Date
MM slash DD slash YYYY

Customer Old Address

Old Address(Required)
Pickup Date
MM slash DD slash YYYY

Details

Was shipment in a warehouse?(Required)
Did employer pay for move?(Required)
What was the declared value protection?
Are you the owner of the goods in question?(Required)

Item #1

Carton Damaged?

Item #2

Carton Damaged?

Item #3

Carton Damaged?

Item #4

Carton Damaged?

Item #5

Carton Damaged?

Item #6

Carton Damaged?

Item #7

Carton Damaged?

Item #8

Carton Damaged?

Item #9

Carton Damaged?

Item #10

Carton Damaged?

Complete & Submit

I am the owner of the property described. I did not cause or contribute to the damage set forth herein. All statements made in this statement of claim and any attached documents are true and correct to the best of my knowledge and belief, and constitute my complete and entire claim. No material information has been withheld. DOT regulations require that any claim for loss, damage or delay must be submitted in writing by claimant and received by carrier within 30 days from date of delivery.
This field is for validation purposes and should be left unchanged.