SAAC MEMBERS ONLY
Letters verifying the value of a car are available by request, at no charge, for SAAC national members. We do not have time to furnish letters to non-members. Once we receive your information and photos we will send you a letter by regular mail. This letter verifies that the value you have placed on your vehicle is consistent with the current market. If your amount is too high or too low, based on present market values from verifiable sources, we will not supply the letter. We have been supplying members with these letters for over 25 years and have yet to have one questioned by an insurance company.

FACTUAL REPRESENTATION

YEAR-MODEL __________________________ SERIAL NUMBER _______________________
FORD SERIAL NUMBER (FOR '65-'66-'67 CARS)_________________________

PRESENT CONFIGURATION (Circle One)
1-Unrestored, Original
2-Unrestored, Slightly Modified
3-Unrestored, Heavily Modified
4-Restored, Original
5-Restored, Slightly Modified
6-Restored, Heavily Modified

PRESENT CONDITION (Circle One)
1-Below Average
2-Average
3-Above Average
4-Excellent
5-Mint/Perfect

OWNER'S ESTIMATE OF PRESENT VALUE $_________________
Please enclose 3 recent color photographs of the car, which show front/side view, rear/side view and engine compartment. They will be returned to you.

The individual(s) listed below is responsible for the factual accuracy of the information contained herein.

NAME_________________________________    SIGNATURE____________________________

ADDRESS______________________________    CITY, STATE, ZIP_____________________


RELEASE
    We understand that the information contained herein will be used by the SAAC, together with photographs provided, to prepare a Statement of Value.  The Statement of Value is a service, provided by the SAAC, to assist members in obtaining the amount of insurance to adequately insure the subject automobile, commensurate with the thinking of the insured member, not the SAAC. The SAAC, with input from the member, will provide a value within a range of values as the price of Cobra and Shelby automobiles have escalated and fluctuated measurably in recent years. Member agrees, as evidenced by the signature affixed hereto, that in no way will the SAAC or the insurance company be held responsible by them for any deficiencies in insured value or coverage, which may result by price escalation or the insured's decision to underinsure or by reason of the Statement of Value or for any reason whatsoever.
    Member understands that the Statement of Value is not a guarantee or warranty, but an opinion based on the market asking price within a range based on condition. Member further understands that damages may occur if member requests a modest or undervalued Statement of Value in order to carry lower insurance coverage and/or premiums.
    Member warrants and represents that the photographs provided are of their automobile, the subject of this fact sheet, and that subject automobile is in the same condition as evidenced by the photos on the date of issuance of insurance.
    Member hereby releases the SAAC, its officers, directors, employees and volunteers from any and all liability of any type or in any amount whatsoever, which may arise as a result of the information contained in this fact sheet or from use of the Statement of Value for any reason or purpose whatsoever.
    These representations, warranties, releases and understandings and agreements are binding upon the heirs, executors, administrators, assigns and trustees of member. Member agrees that in the event of dispute, concerning use of the fact sheet or Statement of Value, that the dispute will be heard and settled in binding Arbitration pursuant to rules promulgated by the American Arbitration Association. The victor thereof shall be entitled to reasonable attorneys fees and Court costs.


DATE________________      SIGNATURE___________________________________
 

Print, fill out, and return with photos to: SAAC, PO BOX 788, SHARON, CT 06069