Online Auto Club ClaimsClaim Status -None- Draft New In Progress For Approval Check Request Awaiting Signature Closed - Paid Denied Closed - Not Paid Inactive Loan office name & city where purchased ?Enter the name of loan company and city where membership was purchasedClub Membership Date ?Enter start date of membership..Submitted By ?First and last name of person submitting claim.Email ?Enter valid email address.Claimant Full Name*PhoneStreet AddressCityStateZip/Postal CodeClaim DetailsAdditional claim detailsUpload a File File(s) size limit is 20MB.