Membership AAA Auto Pay Plan Credit or Debit Cards Terms and

Impor

tant: We must have a

signature to complete this transaction.

Please do not return by e

mail.

AAA East Central

P.O. Box 5386

Pittsburgh, PA 15206-0386

8712

/15

EXPIRE

DATE

Please detach at line.

AUTHORIZATION AGREEMENT FOR MEMBERSHIP CREDIT OR DEBIT CARD P AYMENTS

AAA Auto Pay Plan



To use AAA

uto Pay for your membership, enter your Club Code and Membership Number as it appears on your membership card in the boxes be

low.

 Unless the last 4 digits of your credit or debit card (previously provided to us) have already been filled in, please enter your complete account number

and card expiration date below.

Club Code First 8 Digits of Membership Number

MEMBER #

I hereby authorize AAA East Central ("AAA") to charge my CREDIT or DEBIT CARD ACCOUNT indicated below for all membership dues that become

due by me to AAA. All charges to my Credit or Debit account are governed by the Terms and Conditions that accompanied this Agreement.

Visa®

Discover®

MasterCard®

American Express®

CARD #

This authorization is to remain in full force and effect until terminated by AAA or by me.

NAME OF ACCOUNT HOLDER DATE SIGNATURE OF ACCOUNT HOLDER

AAA Employee #

(if applicable)

Branch/Sec # Membership #

Member Name

Membership AAA Auto Pay Plan

Credit or Debit Cards Terms and Conditions

About 45 days before your AAA membership expires, we, your AAA club, will send a statement of your current services and renewal dues amount. We will

automatically renew your membership and charge the dues shown on your statement to your credit or debit card on file about 15 days prior to your renewal

date, unless you contact us to make a change to or cancel AAA Auto Pay. If we are unable to process the charge, we may cancel your AAA Auto Pay

enrollment and you will be contacted by mail and/or by phone and provided the opportunity to renew by mail or phone or online at AAA.com or your local AAA

branch office. At that time, you may also re-enroll in the program with updated credit or debit card information.

If your VISA, MasterCard, Discover or American Express credit or debit card issuing bank participates in the Card Account Updater program, we may receive

an updated credit or debit card account number and/or expiration date for the card information you have previously provided us, unless you Opt Out of the

service with your issuing bank. We will update our files and use the new information when we bill you under AAA Auto Pay. We won't receive updated

information if your account has been closed. Debit card available with VISA/Mastercard only.

You may update your account number and/or expiration date, change your membership options or cancel AAA Auto Pay at any time by contacting us at 1-800-

441-5008 or at your local AAA branch office.

Please complete the required information on the front of this form. We must have your signature for authorization. By signing this form, you hereby agree to

these Auto Pay Plan Terms and Conditions. Please make a copy of both sides of this form for your records.

To have your membership dues automatically charged to your credit or debit card each year,

Complete and mail the form below using the envelope provided or return to:

M M Y Y