AAA Insurance Services Digital Account Management Customer Activation Form

 

Please complete this form to activate your AAA account

 

 

1. Legal name of Customer      

 

 

2. Business Address

 

Street                                     

City                                         

Country                                    

Zip/Postal Code                     

 

 

3. Legal Address if Different

 

Street                                     

City                                         

Country                                    

Zip/Postal Code                     

 

 

 

4. Jurisdiction of Incorporation / Registration and Registration Number (if any)

 

 

5. Tax Identification Number

 

 

6. Type of Organization

 

 

 

By signing this Customer Activation Form, the Customer acknowledges the receipt and acceptance of AAA’s General Account Conditions and the terms of any Local Conditions for the countries specified. (Please note that some Local Conditions may also have to be signed separately.) The Customer requests AAA to open in its name the Account(s) to be specified in Section 8 of this form or in any other manner acceptable to AAA.