Claim Form for Non-Delivery of Pictures
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Thank you for filling out this form. Please mail form to address below. We will
check the status of your order and delivery. Once we have received confirmation
that the package never reached your residence, we will send you pictures
immediately. Please allow up to three (3) weeks.
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School Name: ______________________________________________________
Student Name:______________________________________________________
Package AMC proof number __________________________________________
Your Name: ________________________________________________________
Date ordered: _______________________________________________________
Package ordered _____________________________________________________
Total amount paid: $_____________________________
Mailing Address (Street) _______________________________________________
City: ________________________________________________
State: _______________________________________________
Zip: _______________________________________________
Day Phone Number: (____)__________- _______________
Evening Phone Number: (____)__________- _______________
E-mail:_____________________________________________________
Type of delivery:
SCHOOL ORDER:
Have you filed a claim at your Parent coordinator office?
YES NO
ONLINE or MAIL ORDER:
Have you filed a claim form at the United States Postal Service regarding your lost mail?
YES NO
I hereby confirm that I have not received the picture(s) I ordered and I have not filed a governmental claim
through the United states Postal Service.
_______________________________ _________________________
Signature Date
Mail Claim Form to: AMC PHOTO Inc., P.O.Box 740-304, Rego Park, NY 11374