Edit, Download, and Sign the AAA Application for Refund Form

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How do I fill this out?

To complete this form, you'll need information about the service you received, including your membership details and receipts. It's important to answer all the questions accurately to ensure quick processing. Once completed, submit the form via email or mail.

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How to fill out the AAA Application for Refund Form?

  1. 1

    Enter your membership number, name, and contact information.

  2. 2

    Provide details of the service received, including date and location.

  3. 3

    Describe the type of service provided and any associated costs.

  4. 4

    Attach relevant receipts, invoices, and other documentation.

  5. 5

    Sign the form and submit it via email or mail.

Who needs the AAA Application for Refund Form?

  1. 1

    AAA members seeking a refund for automotive services.

  2. 2

    Individuals who paid for services at AAA contract rates.

  3. 3

    Members who experienced a vehicle disablement and need reimbursement.

  4. 4

    Those who used AAA services but did not call the AAA HELP number.

  5. 5

    Customers needing documentation for insurance-covered repairs.

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  1. 1

    Upload the PDF form to PrintFriendly.

  2. 2

    Click on the fields to enter your information.

  3. 3

    Add any additional text or annotations as needed.

  4. 4

    Review your entries to ensure accuracy.

  5. 5

    Download the edited PDF for submission.

What are the instructions for submitting this form?

Submit the completed form with all related receipts and documentation to: 600 SW Market Street, Portland, OR 97201. For faster processing, email the completed form and attachments to automotiveservices@aaaoregon.com. If further assistance is needed, contact the Automotive Services Department at 503.222.6787.

What are the important dates for this form in 2024 and 2025?

Ensure to submit your application form promptly. Important dates for submission in 2024 and 2025 will be updated as they become available.

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What is the purpose of this form?

The AAA Application for Refund form is designed to assist members in obtaining refunds for services provided at AAA contract rates. This form ensures that members get reimbursed for eligible expenses related to automotive services. Completing this form accurately and submitting it with the required documentation facilitates faster processing and response from AAA.

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Tell me about this form and its components and fields line-by-line.

This form contains several fields that collect essential information for processing your refund request.
fields
  • 1. Membership number: Enter your AAA membership number.
  • 2. Name: Provide your full name as registered with AAA.
  • 3. Address: Enter your mailing address.
  • 4. Email address: Provide your email address for correspondence.
  • 5. Date of service: Indicate the date when the service was provided.
  • 6. Location of disablement: Enter the city and state where the disablement occurred.
  • 7. Type of vehicle: Specify the year, make, and model of the vehicle serviced.
  • 8. Name of member present: Provide the name of the member present at the time of service.
  • 9. Service provider details: Enter the company name and time the service provider was on scene.
  • 10. Service provided: Select the type of service provided (e.g., Flat Tire, Battery Service, Towing) and describe if other.
  • 11. If accident: Indicate whether the repairs were covered by insurance and provide details.
  • 12. Remarks: Add any additional remarks or explanations as needed.
  • 13. Signature of member: Sign the form to validate your request.
  • 14. For office use only: Fields for office processing and approval.

What happens if I fail to submit this form?

Failure to submit this form may result in not receiving the refund you are entitled to.

  • Delayed Refund: Not submitting the form on time can delay the refund process.
  • Ineligible Claims: Incomplete forms might be rejected, making you ineligible for a refund.

How do I know when to use this form?

Use this form when you need to request a refund for AAA services.
fields
  • 1. Paid Services: When you have paid for services at AAA contract rates.
  • 2. Service Reimbursement: When seeking reimbursement for services provided by AAA.

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How quickly will I receive my refund?

You should receive a written response within fourteen (14) business days after your request is received.

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