Policy Issuance Details

Insured Details

Inception date: (YYYY-MM-DD)

Insured name:

Address:

Town / City:

Country:

Postcode:

Telephone / mobile:

Email:

Is there a co-assured?
YesNo

Is there a mortgage interest?
YesNo

Boat Information

Hull identification number:

Make:

Price paid:

Year of purchase:

Main engine

Select type of motor:
InboardOutboardNone (Sail-only)

Number of engines:

Serial No. Engine 1:

Serial No. Engine 2:

Tenders & Outboards

Tenders:
YesNo

Outboards:
YesNo

Tender Make:

Tender Serial Number:

Outboard Make:

Outboard Serial Number:

Total Horse Power:

Lay Up

Location:

Date from: (YYYY-MM-DD)

Date to: (YYYY-MM-DD)

Flag

Flag/Port or registry:

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