Claimant for Reduced Price

Date: ____________________________________



Claimant’s Name: _____________________________

Address of Claimant: __________________________



Name of Carrier: _____________________________

Address of Carrier: __________________________



This claim for $ ______ (_____________________________ & ____/100 dollars) is made against the carrier named above by _________________________, Claimant, for overcharge in connection with the following shipment(s):


Description of Shipment: ____________________________

Name and address of Shipper: _________________________

Shipped from ____________________________ to ____________________

Final Destination: ______________________ Routed Via ____________

Bill of lading issued by _______________________ (Company) on the ______________ day of _________________, 19___.


Paid freight bill No. _________________ Truck No. _____________

And initials ___________________________,

Name and Address of recipient __________________.

Nature of Overcharge: __________________________





Number of packages __________________, articles  _______________, weight ___________, rate ___________, charges  _____________, amount of overcharge ________________ Dollars.


Authority for rate or classification claimed: __________________________________________


In addition to the information given above, the following documents are submitted in support of this claim:

(___________) 1. Original Bill of lading, if not previously surrendered by carrier.


(___________) 2. Original Paid freight (“expense”) bill.


(___________) 3. Original Invoice or Certified Copy.


(___________) 4. Weight Certificate or certified statement when claim is based on misrouting or valuation.


(___________) 5. Other Particulars obtainable in proof of loss or damage claimed: __________.


Remarks: ________________________________________________________




The above statement of facts is hereby certified as correct.


Dated: ________________________________.







Claimant for Reduced Price

Review List

This review list is provided to inform you about this document in question and assist you with its preparation.  Claims for price reduction are a standard feature of most commercial businesses.  This general format can be adapted to a host of different situations.  The more complete the form appears, the more apt you are to get a reduction in price, whether technically merited or not.


  1. Make multiple copies.  Send one to the signatory by fax and/or mail.  Keep one with the transaction file.  Note a suitable date, such as 7 days later, to follow up by phone to finalize the result.  As with all negotiations, as suggested in our disc of that name, have your end goal in mind when entering into one of these transactions.



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