This form should be completed by the person whose goods were moved.

If the mover is a CAM member, CAM will:

• Record the complaint.
• Recommend appropriate action.
• Refer the matter to the mover for resolution and response.
• If appropriate, refer the matter to the affiliated van line for resolution and response.
• Advise the consumer of action taken on the consumer’s behalf and responses received.
• If appropriate, refer the matter to an independent body, like the BBB, for arbitration.

If the mover is not a CAM member, CAM will:

• Record the complaint, to warn other consumers.

Complainant

Name
Address	City Prov. Postal code
Phone
Fax
Email address

Mover

Company
Contact person
Address	City Prov. Postal code
Phone
Fax
Email address

How did you find this mover?

No response Yellow Pages Newspaper Classified Bulletin Board Personal referral Mover called Other Other:

Why did you choose this mover?

Date of Move

	Scheduled (mm/dd/yyyy)	Actual – if different from scheduled (mm/dd/yyyy)
Packing
Loading
Delivery

Do you have a copy of the moving contract?

No response Yes No

How did you pay for the move?

No response Cash Credit card Cheque My company paid

Describe how your payment was made if payment is part of this complaint:

Nature of Complaint

No response Late arrival or delivery Inaccurate estimate Price differed from original estimate Damaged goods Missing goods Other

Describe the complaint:

What have you done to resolve the complaint?

No action taken
Contacted the mover	Date:
Contacted the Better Business Bureau	Date:
Contacted a government agency	Date:
Other

Describe the actions you have taken to resolve the complaint:

Describe the actions the mover has taken to resolve the complaint:

Who were you dealing with at the moving company regarding this complaint?

What would you feel would be a fair resolution of this complaint?

What has been offered to you?

Thank you for completing this form.

Click ONCE to submit