File a Claim – Moved Within Texas

Dependable Relocation Services, Inc. – INTRASTATE CLAIM FORM

Corporate Headquarters 450 Airline Drive, Suite 100, Coppell, TX 75019 888-461-3737 TxDMV #006779291C

  • MM slash DD slash YYYY

  • MM slash DD slash YYYY

  • Inventory NumberArticle WeightArticle DescriptionDescription of loss/damageDate of purchase/Age of itemCost to replaceAmount ClaimedCarton Damaged (Y/N) 

  • TxDMV regulations require that any claim be submitted in writing and received by carrier within 90 days from delivery of the shipment to the final destination or after a reasonable time for delivery has elapsed in the case of failure to make delivery.
  • Typing your name below will serve as an electronic signature