Warranty Claim Form

After you have submitted your warranty claim form, you will be allocated a "Warranty Claim Reference Number". Once you have this number please also email us the required additional information below:

a) Copy of consignment / job

b) Copy of damage report

c) Digital photographs (if damaged)

d) Cost price invoice / proof of prescribed price from supplier

e) Tax invoice made out to Breeze Logistics for amount claimed

f) Evidence of damage / loss

Please email this additional information to warranty@breezelogistics.com.au (with your "Warranty Claim Reference Number" as the subject) so that we can process you claim as soon as possible.

CONTACT DETAILS:
Business Name:			Customer Number:
Contact Name:			Email Address:
Phone Number:			Fax Number:
CONSIGNMENT INFORMATION:
Consignment Number:			Claim Type:
Date Of Dispatch:			Date Of Receipt:
SENDER DETAILS:			RECEIVER DETAILS:
Business Name:			Business Name:
Pickup Address:			Delivery Address:
Pickup City:			Delivery City:
Pickup State:			Delivery State:
Pickup Postcode:			Delivery Postcode:
CLAIM INFORMATION:
Goods Description:			Loss/Damage Info:
Cost Value Of Claim:			Account Manager:
DECLARATION:
I ACKNOWLEDGE THAT COMPLETION OF THIS FORM IS FOR INCIDENT REPORTING PURPOSES ONLY AND THAT ANY CLAIM WILL BE SUBJECT TO BEING A PARTICIPANT IN THE FREIGHTSAFE WARRANTY PROGRAM AND MY CLAIM BEING APPROVED AS PER THE TERMS AND CONDITIONS. I AM THE LEGAL OWNER OF THE GOODS CONSIGNED AND DECLARE THAT THE ABOVE MENTIONED STATEMENTS ARE TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE.
Your Full Name:			Claim Date:
Your Email:			Your Phone: