Safe Ride Reimbursement Form

Safe Ride
Reimbursement Form
AAA Student members, fill out the information
below, include your original taxi receipt, and mail
within sixty (60) days of Safe Ride to:
AAA MountainWest
Attn: Member Services
PO Box 4129
Helena, MT 59604-4129
Applications received more than 60 days after date of Safe Ride
are not eligible for refund consideration.
Membership Information
Membership Number
Expiration Date
Mailing Address
Email Address
Cell Phone
Other Phone
Date of Safe Ride
Time (am/pm)
Safe Ride Information
Reason for Safe Ride
Location of Pick Up
Distance of Safe Ride
Total Taxi Fare
I verify that all information provided is accurate and true:
For More Information Contact:
AAA MountainWest
Attn: Member Services
PO Box 4129
Helena, MT 59604-4129
1-800-222-2045 ● 406-447-8104 ●
• Include original receipt.
• Submit within 60 days of Safe Ride.
• Please allow 30 days from date we receive this form to
process your request.
Safe Ride Reimbursement 2011 Revised 08.11
AAA Student Safe Ride
Member Benefit
Life is full of uncertainties and your day might not turn out exactly
as planned. If you find yourself stranded or otherwise unable to
get home, we will reimburse the cost of a taxi/cab ride. Limited
to one Safe Ride per membership year, up to $25. This service
is not intended to replace everyday transportation.
This benefit is not counted toward your four allowable service calls.
Request for reimbursement consideration must be received in
writing by AAA MountainWest with the appropriate documentation
within 60 days of the Safe Ride.
Conditions for Reimbursement
Reimbursement Procedure
The following conditions must be met to be eligible for
reimbursement consideration:
Please follow these steps to apply for reimbursement:
1. Must be a Student member of AAA MountainWest in good
2. Fill out the application on the other side of this sheet.
2. Only one cab ride per member, per membership year, will be
eligible for reiumbursement.
3. Request for reimbursement must be received within 60 days
of Safe Ride.
Reimbursement will only be considered for Safe Rides occuring
within AAA MountainWest coverage service area of Montana,
Wyoming and Alaska.
Reimbursement will not automatically equal $25 for Student
members. The member will only be paid for cost of the taxi fare
as shown on original receipt. Reimbursement amounts are subject
to change at any time. Approved reimbursements will be paid by
check, directly to the member.
1. Secure itemized receipt covering the cost of your cab ride.
3. Submit the application and original receipt within 60 days of
the date of the Safe Ride to:
AAA MountainWest
Attn: Member Services
PO Box 4129
Helena, MT 59604-4129
Safe Ride Limitations & Exclusions
Safe Ride benefits do not cover:
1. Safe Rides occurring outside AAA MountainWest service area
of Montana, Wyoming and Alaska.
2. Safe Rides used as everyday transportation; such as rides
to and from work, the gym, school, etc.
Safe Ride Reimbursement Form
Our goal is to process your Safe Ride Reimbursement Form as quickly as possible. Please fully complete the application on the reverse,
enclose your original receipts and return within 60 days of your Safe Ride.
Your Member Handbook has detailed member benefit information.
Review the most recent edition at