Claim Form for Lost/Damaged Items

Before filling out this form please review our Best Practices for lost/damaged claims.

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. Forward all damaged items to the MLS Marlboro office via the delivery service. Please note that reimbursement for items may take up to two months from the time the claim is submitted.

Please do not fill this form out to report a lost item which has been found! Contact Debra Rachlen if you have the item!

Date of Incident (mm/dd/yyyy):

Owning Library:

Address

City State Zip

Phone

Contact

Contact's Email

Check the appropriate box

 Lost Damaged

Description of item

Please describe damage to item:

Please enter item specific library barcode:

Price

Make check payable to

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