Claim Form for Lost/Damaged Items

Before filling out this form please review our Best Practices Lost Damaged Items.

Please fill out this form for items that were either lost or damaged in delivery. After submitting the form, you will receive an email with the details of your claim. Please keep this for your records. If you have multiple items, please fill out a separate form for each item. Forward all damaged items to the MLS Marlboro office via the delivery service, using a “C” routing slip, with attention to: Caitlin.

Lost items must be lost at least two months after the transaction date before a claim can be submitted. Lost items submitted before the two months will not be accepted and will have to be resubmitted once the two month waiting period has passed.

Please note that reimbursement for items may take a few months from the time the claim is submitted.

Please do not fill this form out to report a lost item which has been found! In the event that an item turns up, please contact Caitlin Davis if you have the item so that we may cancel the claim.

Date of Incident (mm/dd/yyyy):

Owning Library:

Address

City State Zip

Phone

Contact

Contact's Email

Check the appropriate box

 Lost Damaged

Title of Item & Item Format (Book, DVD, etc.)

Please describe damage to item (if applicable):

Please enter item specific library barcode:

Price

Make check payable to

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