apps.texas.aaa.com Open in urlscan Pro
65.161.129.121  Public Scan

Form analysis
3 forms found in the DOM

/content/ace-www/en/search-results-G

<form action="/content/ace-www/en/search-results-G" role="search" onsubmit="return false;" class="nav-search-form">
  <div class="input-group search-bar">
    <span class="input-group-addon">
      <i class="glyphicon glyphicon-search" aria-hidden="true"></i>
    </span>
    <div id="cludo-search-form-top" role="search">
      <label for="cludo-search-form-input">Search this site</label>
      <input name="searchrequest" id="cludo-search-form-input" type="search" placeholder="Search" value="" title="Type search word" autocomplete="off" aria-autocomplete="list" aria-haspopup="true">
      <button type="button" title="Search"></button>
    </div>
    <span class="input-group-addon"><i class="close-icon" id="d-close-searchbar">+</i></span>
  </div>
</form>

<form id="cludo-search-mobile-form" role="search" onsubmit="return false;" class="nav-search-form">
  <div class="input-group search-bar">
    <span class="input-group-addon">
      <i class="glyphicon glyphicon-search" aria-hidden="true"></i>
    </span>
    <input type="search" name="q" id="q" placeholder="Search" class="form-control font-h" autocomplete="off">
    <span class="input-group-addon">
      <i class="close-icon" id="m-close-searchbar">+</i>
    </span>
  </div>
  <input type="submit" title="GO" value="GO" class="btn-style btn-sm btn-border btn-color-blue ">
</form>

Name: startForm —

<form role="form" data-ace-form-validation="" data-ace-validator-options="vm.validateConfigOptions" data-form-scope="this" novalidate="" name="startForm" id="policyInfoForm" data-di-form-track="" data-di-form-id="policy-info"
  class="ng-scope ng-isolate-scope ng-pristine ng-invalid ng-invalid-required">
  <!--<input name="__RequestVerificationToken" type="hidden" value="wWv5FwextKs6kcqhWwVfJUEf-VnIxPcpGMZOkXlOvCdnSzGYB5KnnB2yn3SRMccgsZ1loQ9-yEw8spucmKtd1Ug92XlCG5QpE5gf88qxEM0cQ29u_2vvBsxY8WNNGkIg04RPBw2">-->
  <div class="row-fluid">
    <h2>Insurance Questionnaire <small>Policy Authentication</small></h2>
    <!-- ngIf: vm.ClubCode == 004 || vm.ClubCode == 036 || vm.ClubCode == 252 || vm.ClubCode == 601 || vm.ClubCode == 065 -->
    <p data-ng-if="vm.ClubCode == 004 || vm.ClubCode == 036 || vm.ClubCode == 252 || vm.ClubCode == 601 || vm.ClubCode == 065" class="ng-scope"> To receive a <strong>Verified Mileage Discount</strong> at renewal, login below and continue to the
      following page to enter the current odometer reading for each eligible vehicle on your policy. </p><!-- end ngIf: vm.ClubCode == 004 || vm.ClubCode == 036 || vm.ClubCode == 252 || vm.ClubCode == 601 || vm.ClubCode == 065 -->
  </div>
  <div class="row-fluid active-form">
    <div class="row-fluid bottom-margin-20">
      <div class="col-md-12 col-sm-12 col-xs-12">
        <div class="row">
          <!-- ngIf: !vm.isEmpty(vm.model.NotificationMessage) -->
        </div>
        <div class="row">
          <div class="col-md-12 col-sm-12 col-xs-12">
            <!-- ngIf: !vm.model.IsPolicyNoEncrypted -->
          </div>
        </div>
        <div class="row">
          <!-- ngIf: !vm.model.IsPolicyNoEncrypted -->
        </div>
        <div class="row">
          <div class="col-md-12 col-sm-12 col-xs-12">
            <span class="field-validation-valid" data-valmsg-for="PolicyNo" data-valmsg-replace="true"></span>
          </div>
        </div>
        <div class="row">
          <div class="col-md-12 col-sm-12 col-xs-12"><label for="Pin">Date of Birth</label></div>
        </div>
        <div class="row">
          <div class="col-md-4 col-sm-12 col-xs-12">
            <input data-di-mask="" autocomplete="on" class="startPassword col-xs-12 ng-isolate-scope ng-pristine ng-invalid ng-invalid-required ng-valid-minlength ng-valid-regexpattern" id="Pin" maxlength="10" data-ng-minlength="10"
              placeholder="MM/DD/YYYY" name="Pin" tabindex="2" type="text" data-ng-model="vm.Pin" data-ng-required="true" ng-keypress="vm.submit($event)" data-format-number="" data-format-type="date" data-ace-field-validation=""
              data-ng-regexpattern="regexpattern" data-ace-pattern-validation="" required="required">
          </div>
          <div class="col-md-8 col-sm-12 col-xs-12">
            <p style="padding: 8px 0px 8px 0px;"><b>(Example : 10/05/1965)</b></p>
          </div>
        </div>
        <div class="row">
          <div class="col-md-12 col-sm-12 col-xs-12">
            <span class="field-validation-valid" style="padding: 1px" data-valmsg-for="Pin" data-valmsg-replace="true"></span>
          </div>
        </div>
        <!--
                <div class="col-md-4 col-sm-12 col-xs-12" data-ng-if="!vm.model.IsPolicyNoEncrypted">
                    <div class="pull-right clearfix hidden-phone">
                        <div class="mediahero">
                            <p style="margin-bottom:0;">Example Policy Number:<strong>&nbsp;<label data-ng-bind-html="vm.samplePolicyNumber"></label></strong></p>
                            <p style="margin-bottom:0;"><small>(12 characters with no spaces)</small></p>
                        </div>
                    </div>
                    <div class="visible-phone">
                        <div class="mediahero">
                            <p>Example Policy Number:<strong><label data-ng-bind-html="vm.samplePolicyNumber"></label></strong></p>
                            <p><small>(12 characters with no spaces)</small></p>
                        </div>
                    </div>
                </div>
                    -->
        <div class="row-fluid col-md-12">
          <input type="button" class="btn btn-primary btn-large" value="Proceed" tabindex="3" data-ace-form-submit="" data-ace-form-submit-func="vm.proceed()">
        </div>
        <div class="loading-indicator hidden"></div>
      </div>
    </div>
  </div>
</form>

Text Content

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INSURANCE QUESTIONNAIRE POLICY AUTHENTICATION

To receive a Verified Mileage Discount at renewal, login below and continue to
the following page to enter the current odometer reading for each eligible
vehicle on your policy.

Date of Birth

(Example : 10/05/1965)




Copyright © 2024 AAA Texas, LLC. All Rights Reserved. | Privacy policy |
Accessibility | Terms of use | Site map | Find a different AAA club
AAA Texas is a member club affiliated with the American Automobile Association
(AAA) national federation and serves members in the state of Texas (with the
exception of Texarkana).
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