ASTA Parking - Claim Form



Disclaimer on valet ticket: THIS CONTRACT LIMITS OUR LIABILITY - PLEASE READ IT " Customer and Company agree as follows: Customer agrees to inspect car before leaving lot. Customer's claim of damage or loss must be reported and itemized in writing on Company's form before car is taken from auto park following a claim of loss, and if not so made, any such claim is waived by Customer. Should Company agree to make repairs to customers car at it's expense, Company has option within 48 hours after filing of claim to choose the place and the person to make repairs. No liability is assumed by Company for loss or damage by fire, theft, vandalism, mechanical failure or act of nature to any vehicle. No liability is assumed by Company for vehicles left after closing hours.
Disclaimer on booth: POLICY: All claims for adjustment must be presented before vehicle is taken from facility. No liability is assumed by Asta Parking for loss or damage by fire, theft, vandalism, mechanical failure or act of nature to any vehicle. No liability is assumed by Asta Parking for cars left after closing hours.
Name Street Address City, State, Zip Contact phone number Email address Name of establishment where incident occurred Street address of establishment City, State, Zip of establishment Date of incident Arrival Time Departure time When did you notice the damage on your vehicle? What is the make of your vehicle? What is the model type of your vehicle? What is the model year of your vehicle? What is the color of your vehicle? Description of alleged damage Select Select Select Select Select Photos of alleged damage. (max. size 1 MB) Additional Information