AAA North Jersey
418 Hamburg Turnpike
Wayne, NJ 07474


For emergency service provided by non-AAA facilities when AAA service is available, please submit your request for reimbursement consideration under the terms of the membership up to the amount it would have cost AAA to provide service under similar circumstances. Except on limited access roads, Members must make every effort to secure AAA service first. To apply for reimbursement consideration, please submit the original receipt within 60 days of the date of service. Please allow three weeks for processing.


First Name*: Last Name*:
Membership Number*: 620-075- Email Address*:
Address 1*: Address 2:
City*: State*:
Zip Code*: Phone*:
Vehicle Driver*: Vehicle Type*:
Service Date*: Service Time*:
Year/Make Model*: Type of Service:
Breakdown Location*: Towing Milleage*:
Vehicle Towed to*: Total Charges*:
Name of Service Facility*: Breakdown Reason*:
Was AAA Called*: Police Involved*:
What Number was Used*: Why was AAA service not used?*:
Advise if you wish to have the original receipt returned to you?*: Date*:

*Required field