Transcription of Roadside Assistance (RSA) Refund Application
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Roadside Assistance (RSA) Refund Application
Refund Application Include all original receipts. Submit within 60 days of service. If not a AAA MountainWest member please submit thiscompleted Application , with receipts, to your home club. Please allow 30 days from date we receive this form toprocess your NumberExpiration DateNameStreetCity State ZIPDay phoneMeMbership inforMationE-mail AddressFor More Information Contact:AAA Automotive ServicesPO Box 24502 | Oakland, CA PhoneName of facility that rendered road serviceDate of service Time (am/pm)What service was rendered (battery jump, change of flat, tow, etc.)?Where was the member at time of service?Did you call AAA for service?What telephone number did you call for Assistance ? Yes NoDid you sign a AAA service ticket? Yes NoWas a valid AAA membership card presented? Yes NoIf "YES" to any of the above, why you were charged?
For fast, reliable and flexible roadside assistance just call 1-800-AAA-HELP (1-800-222-4357). RSA Reimbursement Application Our goal is to process your Roadside Assistance refund application as soon as possible.
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