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Norfolk Southern Overcharge Claim Form

Please complete the fields below to start the Claim process.
- Required fields are marked with *


* Nature Of Claim
Rate error Duplicate payment Over payment Weight error Prepaid vs collect dispute Rule 11 vs through rate Incorrect customer billed Other
Contact Information
* Company Name:
* Remit to Address:
* City/State:
* Zip:
Federal Tax Id Number:
* Phone:
Fax:
E-mail:
Today's date:
Date Filed (ex: mm/dd/yyyy):
Internal Claim Number:
* Equipment
You may enter up to 20 entries below.
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Freight Bill Number: or	Car info:
	Initial: Number:
	Shipment Date:
Claimed Amount For This Bill:
Total Claimed Amount
$0.00
Claim Description
Please provide a detailed description of the overcharge:
Attachment
Please provide supporting document (s) that will assist in the processing of your claim request. Image taking too long to upload? Try reducing their size with image editing software.



* Signature
The undersigned being unable to furnish original bill of lading and/or original paid freight bill account lost or destroyed hereby guarantees to protect the Norfolk Southern Corporation and any interest carrier against all loss, damage, cost, and attorney's fee which may result from payment of this claim without surrender of original documents.
The forgoing statement of facts is hereby certified as correct.
Type your name:

Norfolk Southern Overcharge Claim Form

* Nature Of Claim

Contact Information

* Equipment

Total Claimed Amount

Claim Description

Attachment

* Signature