Customers
Protection – Liability Damage Waiver
Payment Options
Customer Reviews
About Us
Dealers
Dealer Portal
FAQs
Rent-To-Own
Why Rent-To-Own
How Rent to Own Works
Contact Us
Find a Location Near You
Building Pickup Request
Liability Damage Waiver Signup
Liability Damage Waiver: Submit Claim
Move Quote Request
Repair Request
Request for Payment Booklet
Update Account Information
NEW! Introducing PMB’s Roll-Off Lease Container Program!
✕
Liability Damage Waiver: Submit Claim
Home
Contact Us
Liability Damage Waiver: Submit Claim
Account Number
*
Name on Account
*
Requesting Party (if not customer)
Main Phone
*
Alternate Phone
Email
*
Address of Building Location
*
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Is your Mailing address different than the address of the building?
*
Yes
No
Mailing Address
*
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Date of Incident
MM slash DD slash YYYY
Is the building a total loss?
Yes
No
Details of incident
*
Fire/Theft reports
In case of a fire - You must attach a fire report.
In case of a theft - You must attach a police report.
Drop files here or
Select files
Accepted file types: pdf, doc, docx, Max. file size: 16 MB, Max. files: 2.
ALL PAYMENTS MUST BE CURRENT AT THE TIME OF INCIDENT
ALL CLAIMS MUST BE SUBMITTED WITH PROPER PAPERWORK WITHIN 30 DAYS OF DAMAGE OR LOSS
By submitting this request, I acknowledge that all information submitted herein is accurate. I understand that my account must be current (all payments, late fees and LDW fees) at the time of incident. If my account is not current, I understand that I will be responsible for all repairs needed. If the building is a total loss, I understand that I will be responsible for the Fair Market Value of the building. LDW does not cover damage caused by water, moisture, scratches, mysterious disappearance, vandalism, abandonment, or any other intentional damage by renter. Theft must be reported to the police and the police report must be provided at the time the claim is made. Damage caused by fire must be reported and an official report must be provided at the time the claim is made.
Phone
This field is for validation purposes and should be left unchanged.
Δ
NEW! Introducing PMB’s Roll-Off Lease Container Program!