By submitting this form, you (1) agree all the information you
provide is correct and (2) agree to fully cooperate in the investigation or
prosecution of any person responsible for any violation of law giving rise to
the request for partial reimbursement.
To qualify for partial reimbursement, SFMTA must determine that
you are eligible.
If SFMTA determines you are eligible, the maximum dollar amount
SFMTA will reimburse you is the amount in fees you paid in excess of the
reduced fees for which SFMTA determines you are eligible. A check will be mailed to the address you
You are responsible to notify the SFMTA immediately if you move or
change your mailing address.
When you complete this submission, you will be given a Case
reference number and the email address to notify us of any changes.
Submitting this form to SFMTA does not guarantee you will receive
partial reimbursement of the administrative fee you paid for towing and storage
of your vehicle.