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 and you wish to receive reimbursement for these items. 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 claim form for each item.

Please keep in mind the following when filling out the lost/damaged form:

Lost items must be lost at least two months after the incident 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.
MLS will not consider claims for lost items that have been missing in transit for over one year.
All damaged items must be forwarded to the MLS Marlboro office via delivery, using a ā€œCā€ routing slip, with attention to: Caitlin. Please do not discard any damaged items you are seeking reimbursement for.
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):

-If the item is lost, please use the date the item was put in transit.

-If the item is damaged, please use the date the item was damaged in delivery.

Owning Library:


City State Zip



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:


Make check payable to