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DUPONT SHIPMENT ROUTING GUIDE

CLAIMS ENTRY FORM
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Submitted to Carrier/Paperwork Received Complete Calendar Entered Modified Sent Date
Carrier Code
Carrier Name*
Domestic(N.AMER,CAN,MEX) International
Domestic Claim Checklist  International Claim Checklist 
Claim Type*
Claim Date
Claim Code*
Claim No
Status
Correspondence :*
Complaint#
Claimant*
Ph No.*
Email*
Call Procurement
Letter Disputed
Paid
Date Paid
Claim Amount
Carrier Cargo Liability/Contract Limit
Amount Paid
File Attachment :
Acknowledgement# PO#
Acknowledgement Date Invoice#
Credit Invoice
Bill of Lading Pro# GL Code Sub Code
Ship Date SID Ship Pt SBU
Shipper City State/Province
Consignee City State/Province
Currency
Salvage
Product*  Units Qty/Wt Rate       Value    Rate Salvage Net Value
                                                                                                                                                                Total Claim Amount:





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