Postal Claim Form PDF Details

The USPS offers a Postal Claim Form to help customers file a claim for mail that was not delivered or that was damaged in transit. The form can be used to request a refund or to have the package replaced. In order to file a successful claim, you will need to provide documentation and evidence that the item was not delivered or was damaged. To get started, download and print the form, fill it out, and send it in to the address listed on the form.

We have gathered some basic information regarding the postal claim form. You may want to learn its size, the typical time necessary to fill out the form, the blanks you will have to fill in, etc.

QuestionAnswer
Form NamePostal Claim Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namespostal damaged packages, form postal claim, postal claim, missing package form

Form Preview Example

Revised 08/06

FOR PARCEL INSURANCE PLAN POLICYHOLDERS USE ONLY

US POSTAL SERVICE (USPS) CLAIM FORM

For Lost or Damaged Packages -

INSTRUCTIONS:

1.Complete and mail this claim form no earlier than 30 DAYS and no later than 180 DAYS from shipment date.

2.Attach a copy of your original invoice to the consignee.

3.Attach a copy of the correspondence from the consignee advising you of the loss.

4.If at all possible, attach: A. A copy of the USPS tracer form. The USPS reply is not needed.

We advise filing a tracer for all lost USPS packages whether or not you send a copy to us.

B.A copy of the check from USPS, if you insured part of the value with USPS.

C.A copy of the U.S. Postal Service Delivery Confirmation Receipt, if applicable.

D.For computerized shipping system users only - Copy of shipping system daily report detailing amount of claim insured with PIP.

5.Mail to: PARCEL INSURANCE PLAN, P. O. BOX 66708, ST. LOUIS, MO 63166-6708.

Or FAX to: 314-692-7598 (include all requested documentation)

CLAIM PAYMENT FORM

Insured's Name____________________________________________________________ Policy # _______________________

Address Shipped From:_____________________________________________________________________________________

Consignee's Name __________________________________________________

Invoice # _____________________________

Date Mailed___________________

[ ] Loss

[ ] Damage

[ ] Shortage

Number of Packages _____________

You or consignee should hold damaged items in the event they are requested during claim processing.

FAILURE TO RETAIN DAMAGED PROPERTY COULD AFFECT FINAL SETTLEMENT OF THE CLAIM.

Description of Items____________________________________________________________________________________

Amount of claim: Invoice or repair cost of contents lost or damaged,

$_____________________

excluding shipping fees:(Amount cannot exceed value declared upon shipment)

 

Less amount paid by USPS, if any:

$_____________________

Less salvage value of damaged goods:

$_____________________

Balance to be paid by PIP:

$_____________________

The balance of your unpaid claim will be forwarded to you promptly upon receipt of this completed claim form and

items noted in "2, 3, and 4" of the above instructions.

I certify that the above statements are correct.

Signature______________________________________ Send check to attention of:________________________________

Telephone (____)_______________________________ Ext.________

Email Address: ___________________________________________

Fax No. (

)

Date ________________

FOR PIP USE ONLY

AMOUNT: $_______________________

DATE: _________ BY:_____________

Warning: Any fraudulent claims will make the shipper and/or consignee liable for prosecution for mail fraud under the Federal Criminal Code.

If we have not responded to your claim within 3 weeks of filing, you may check the status of

your claim at www.pipinsure.com.

Watch Postal Claim Form Video Instruction

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