Report damage to a racing or qualifying sulky at a PHHA pari-mutuel or Pennsylvania independent fair track.
Where and when the sulky was damaged.
Enter the track where the accident happened.
Enter the date of the accident.
Choose one.
Everyone named here must be a paid PHHA member on the date of the accident.
Enter at least one owner.
Enter the programmed trainer.
Enter the driver.
The sulky must be USTA approved and registered.
Enter the name of the horse.
Enter who is repairing the sulky.
Enter the sulky make.
Enter a four-digit year.
Wheel damage is reimbursed up to $250.
Describe the accident, including who verified the damage — the presiding judge or a PHHA representative.
Include the race or qualifier number and the time of day if you have them.
Describe what happened.
Typing your name below has the same effect as signing the paper form.
Confirm the statement above before signing.
Type your full name.
Type your name to sign.
Enter today's date.
Leave this section blank. The office fills it in when the claim is reviewed.
