ERS Reimbursement

EMERGENCY ROAD SERVICE REFUND APPLICATION

Dear Member;

The following information is necessary in order to ensure prompt consideration for reimbursement in accordance with your membership benefits. Please complete form and attach original paid receipt.

Fill out the form w/original paid receipt within 60 days of service for consideration.

First Name*

Last Name*

AAA Membership Number

Exp Date

Street Address*

City*

Zip Code*

Phone Number*

Email*

Did you call AAA’s 24-hour Emergency Road Service number when breakdown occurred?*

Yes No

Date of Service

Time of call

Service Call Address

Service Call City

Service Call Zip

Type of service received*

Location of vehicle at time of breakdown

Was your vehicle towed?

Yes No

Make and Model of the vehicle

Year of the vehicle

Amount paid for Emergency Road Service

ATTACH ORIGINAL PAID RECEIPT

Please select a file

Reason for charges

IF ACCIDENT ATTACH POLICE REPORT

Please select a file

Driver of the vehicle at time of disablement

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ERS Reimbursement

EMERGENCY ROAD SERVICE REFUND APPLICATION

You could save up to $694 on your auto insurance!

Don’t wait for thieves to steal your personal information. ProtectMyID Essential - Free for AAA Members

Now offering Boat registration renewals and title transfers!

Looking for lowest Price Gas? Download Our App! Available for Apple and Android.

When you’re not here; make sure your family is protected on that day with Life Insurance. AAA Members get 10% off certain Policies.

Introducing the new way to maximize cash back and accelerate earnings - AAA Visa

Get up to $200 when you switch the family to T-Mobile; For details, click here

Pay 45% less than leading competitors on 2 lines with T-Mobile – For Ages 55+

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EMERGENCY ROAD SERVICE REFUND APPLICATION