INSTRUCTIONS

FOR COMPLETING YOUR CLAIM FORM

• On the claim form on the following page, tab to each field and type in the appropriate information

• Print the form

• Sign the form

• Fax the form to Rossiter Relocation's Claims Department at  925-371-0786

~OR~

Mail the form to Rossiter Relocation, ATTN:  Claims Department, 6475 Las Positas Road, Livermore, CA  94551

• If you need more line items than the lines provided, complete multiple forms

• Click here to continue to the Claim Form