File a Claim

Please complete this form after reviewing our terms and conditions either on the back of your invoice or at https://miraclemoversutah.com/terms-conditions/.

Name(Required)

First Last

Email(Required)

Phone(Required)

Date of your move (mm/dd/yyyy)(Required)

How many items are you submitting in your claim?(Required)

Item #1

Item Make and Model(Required)

Serial Number or SKU, if appliable

Nature of Damage or Loss(Required)

Approximate Weight of Item(Required)

Photos of Damaged Item, Proof of purchase, Specification sticker/sheet, etc(Required)

Drop files here or

Max. file size: 256 MB.

Item #2

Item Make and Model(Required)

Serial Number or SKU, if appliable

Nature of Damage or Loss(Required)

Approximate Weight of Item(Required)

Photos of Damaged Item, Proof of purchase, Specification sticker/sheet, etc(Required)

Drop files here or

Max. file size: 256 MB.

Item #3

Item Make and Model(Required)

Serial Number or SKU, if appliable

Nature of Damage or Loss(Required)

Approximate Weight of Item(Required)

Photos of Damaged Item, Proof of purchase, Specification sticker/sheet, etc(Required)

Drop files here or

Max. file size: 256 MB.

Item #4

Item Make and Model(Required)

Serial Number or SKU, if appliable

Nature of Damage or Loss(Required)

Approximate Weight of Item(Required)

Photos of Damaged Item, Proof of purchase, Specification sticker/sheet, etc(Required)

Max. file size: 256 MB.

Item #5

Item Make and Model(Required)

Serial Number or SKU, if appliable

Nature of Damage or Loss(Required)

Approximate Weight of Item(Required)

Photos of Damaged Item, Proof of purchase, Specification sticker/sheet, etc(Required)

Drop files here or

Max. file size: 256 MB.

Item #6

Item Make and Model(Required)

Serial Number or SKU, if appliable

Nature of Damage and Loss(Required)

Approximate Weight of Item(Required)

Photos of Damaged Item, Proof of purchase, Specification sticker/sheet, etc(Required)

Drop files here or

Max. file size: 256 MB.

Item #7

Item Make and Model(Required)

Serial Number or SKU, if appliable

Nature of Damage or Loss(Required)

Approximate Weight of Item(Required)

Photos of Damaged Item, Proof of purchase, Specification sticker/sheet, etc(Required)

Drop files here or

Max. file size: 256 MB.

Item #8

Item Make and Model(Required)

Serial Number or SKU, if appliable

Nature of Damage or Loss(Required)

Approximate Weight of Item(Required)

Photos of Damaged Item, Proof of purchase, Specification sticker/sheet, etc(Required)

Drop files here or

Max. file size: 256 MB.

Item #9

Item Make and Model(Required)

Serial Number or SKU, if appliable

Nature of Damage or Loss(Required)

Approximate Weight of Item(Required)

Photos of Damaged Item, Proof of purchase, Specification sticker/sheet, etc(Required)

Drop files here or

Max. file size: 256 MB.

Item #10

Item Make and Model(Required)

Serial Number or SKU, if appliable

Nature of Damage or Loss(Required)

Approximate Weight of Item(Required)

Photos of Damaged Item, Proof of purchase, Specification sticker/sheet, etc(Required)

Drop files here or

Max. file size: 256 MB.

By submitting this claim,(Required)

I am acknowledging that this is my full and complete claim. Once a claim form is submitted, no further claims may be submitted.

File a Claim

Item #1

Item #2

Item #3

Item #4

Item #5

Item #6

Item #7

Item #8

Item #9

Item #10

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