SUBMIT A CLAIM

Use this form to advise Lebrock Logistics of any possible damages you may have incurred.
IMPORTANT: This form is provided WITHOUT PREJUDICE.
By providing this on-line web form, for the submission of a possible claim for damages, Lebrock Logistics is in no way accepting liability for your loss. However, Lebrock Logistics does commit to a code of good conduct and will endeavour to investigate your submission thoroughly and respond to your submission as soon as possible.
* Required

Customer Details

Contact Details

Company Name (Entity) *

Contact Name *

Personal Preferences *

Contact Number *

Email Address *

Customer Details

Claim Details

Date of Loss*

Registration Number *

Nature of claim *

Short description of damages *

Other reference

Declaration*
I hereby acknowledge that I (in my personal capacity or as an authorised representative of the above Entity) accept that all loads contracted to Lebrock Logistics are subject to their Standard Trading Conditions.

I Accept

REQUEST A QUOTE

We thank you for your interest in our company and a representative will contact you within 24 hours to help you with your request.

SUBMIT A CLAIM

If you need to submit a claim please complete the form in its enterity and submit it to us.

CREDIT APPLICATION

Download our credit application and email it or fax it back to us.