Aaa Roadside Assistance Nc Form PDF Details

When unexpected troubles arise on the road, the peace of mind knowing you can get assistance makes all the difference. That's where the AAA Roadside Assistance NC form comes into play. It serves as a straightforward pathway for members in North Carolina to request a refund for expenses incurred during a roadside assistance service. This important document needs to be submitted to AAA Carolinas within a strict 60-day period following the service date to be eligible for reimbursement. Members are required to fill out the entire form carefully to avoid any delays with their refund. The form collects essential information such as the member's name, address, contact details, AAA membership number, and specifics about the service received, including the type and location of the vehicular problem, how assistance was sought, and whether the member was present at the scene. It also inquires about whether the AAA's 24-hour hotline was called, reasons for possibly not calling it, and additional crucial details like vehicle towing and the presence of an accident. Attachments, like a copy of the police report in case of an accident and the original receipt of the emergency roadside service, are necessary to support the refund request. This comprehensive approach ensures that all reimbursement claims are handled with accuracy and fairness, reflecting AAA's commitment to serving its members efficiently.

QuestionAnswer
Form NameAaa Roadside Assistance Nc Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesJumpstart, applying aaaaa, Exp, AAAs

Form Preview Example

Return completed form to:

AAA Carolinas

P.O. Box 29600

Charlotte, NC 28229

Attn: Member Relations Dept.

Questions? Call us at 1-877-282-3682

APPLICATION FOR REFUND OF ROADSIDE ASSISTANCE SERVICE EXPENSES

Requests must be submitted within 60 days from date of service.

Please complete entire form or refund may be delayed.

Member’s Name ____________________________________________________________________________________

Address __________________________________________________________________________________________

City_________________________________________ State _________________________ Zip___________________

Telephone: Home (_____) _________________ Work (_____) ________________ Cell (_____) _________________

E-mail Address _____________________________________

AAA Membership Number___________________________________________________ Exp. Date __________________

Date Service was Rendered _______________________

Time ____________________________

Type of Vehicle: Make __________________________

Model ________________________ Year __________________

Location of Disablement ______________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

Nature of Trouble: ฀ Jumpstart Battery

฀Tire Change ฀ Gas

฀ Lock-out ฀ Tow ฀ Other

Please explain how you acquired assistance: ฀ Called AAA Office

฀ Passing motorist called garage

฀ Located nearest garage on your own

฀ Called AAA garage direct ฀ Police called nearest garage

If AAA’s 24-hour toll-free hotline was not called, please explain why: _____________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

Were you driving or riding in the vehicle when it broke down? ฀ Yes ฀ No

Were you present when the service driver arrived? ฀ Yes

฀ No

Did you provide a valid AAA Mmembership card to the service driver? ฀ Yes ฀ No

Was your vehicle involved in an accident? ฀Yes ฀No

(If “Yes,” please attach copy of police report.)

Was your vehicle towed? ฀ Yes ฀ No

 

If “Yes,” where was it towed? From _____________________________ to __________________________________

Approximate mileage vehicle was towed ___________________________

Amount paid for Emergency Roadside Assistance only $ ___________________

(Please attach original paid receipt and retain a copy for your own records.)

Note: If your vehicle was involved in an accident and collision insurance was in force, please submit your bill to the insurance company for reimbursement.

Additional comments: ________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

Date _____________________ Member’s Signature ______________________________________________________

MB-158701-18 (12/18)

How to Edit Aaa Roadside Assistance Nc Form Online for Free

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As a way to complete this PDF document, be sure to type in the necessary details in each and every blank:

1. To start off, when filling out the Jumpstart, start with the area with the next blanks:

Simple tips to fill in AAAs portion 1

2. The subsequent step is usually to submit all of the following fields: Were you present when the service, Yes, Did you provide a valid AAA, Yes, Was your vehicle involved in an, No If Yes please attach copy of, Was your vehicle towed, Yes, If Yes where was it towed From to , Approximate mileage vehicle was, Amount paid for Emergency Roadside, Please attach original paid, Note If your vehicle was involved, please submit your bill to the, and Additional comments .

Tips on how to complete AAAs step 2

A lot of people generally get some things wrong while filling in Note If your vehicle was involved in this section. Be certain to re-examine everything you type in here.

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