ICS Loss and Claim Form
Please fax or mail completed claim form with copy of applicable waybill and an invoice for the product contained in the shipment.
For further information or assistance, please contact our Customer Services Department @1-888-ICS-TRAX(1-888-427-8729)
CLAIMANT'S INFORMATION
Account No :    
Company Name : Contact Name :
Company Address : Postal Code :
Tel Number : - Fax Number : -
 
PARCEL INFORMATION
PIN (if applicable) : Trace Reference No:
Amount Claimed : Date Shipped :
Reason for Claim :
Lost Damaged Item Lost from Damaged Parcel
Service :
ICS Ground™ ICS WorldWide™ ICS Next Day™ ICS Click ’n’ Ship™ Other
 
SENDING INFORMATION RECEIVER INFORMATION
Company Name :
Contact Name :
Addrees1 :
Address2 :
Postal Code :
Company Name :
Contact Name :
Addrees1 :
Address2 :
Postal Code :
 
CLAIM CHECKLIST (Please ensure the following information is also attached)
Copy of Manifest/Waybill Copy of Wholesale Cost Invoice If Damaged, Picture of Damaged Item
  
  
I hereby certify that all information on this form and its supporting documentation is true
__________________________________
Claimant's Signature
__________________________________
Claimant's Name (printed): 		____________________
Date

 
Please note: All requests missing checklist items will be denied due to missing information. Please send all claim requests and supporting documentation to:

Mailing address: ICS Courier – Claims Dept, 2355 32 Avenue, Lachine, QC, H8T 3G9
By fax: 1-866-748-1029 or email: claims@ics-canada.net