Formerly, Offshore Financial and JustBoatLoans.
Continue to Site
CLOSING DATE/EFFECTIVE DATE:
NAMED INSURED (*)
Phone
Address (*)
City (*)
State (*)
Zip (*)
Email (*)
Occupation
Date of Birth (*)
Driver’s License #/State (*)
Additional Operators (name and date of birth)
List Prior Vessels Owned (Length and Kind of Vessel)
Years as a Boat Owner
Years of Marine Experience
Boater Safety Courses taken
Prior Losses?
Year (*)
Length (*)
Make (*)
Model (*)
Hull ID (*)
Hull Material FiberglassWoodOther
(*) SingleTwinTripleQuadOther
(*) GasDiesel
(*) InboardOutboardI/OSail
Engine Year
Manufacturer (*)
Horse Power (total) (*)
Serial Number(s)(*)
Survey Available?
Racing or Charter use
Max Speed
Summer Location
At DockMooring
Winter Mooring
In WaterOut of Water
Layup Period (12/1- 5/1 Standard)
SAFETY EQUIP: GPSRadarShip To ShoreDepthCO DetectorFire Suppression
NAVIGATION LIMITS Other Navigation: Maine to Morehead City, NC 7 Month NavigationInland Waters (Non-Salt) 7 Month NavigationAtlantic Coastal Waters 7 Month Navigation*Inland Waters (Non-Salt) 12 Month NavigationAtlantic Coastal Waters 12 Month Navigation* between Eastport ME to Pensacola, FL *From June 30th to November 1st navigation is restricted to Eastport, ME to Morehead City, NC
Boat and Motor Value $ (Survey Value, Purchase Price, BUC Value)
Amount Financed?
Tender?
Trailer?
Will applicant be living aboardNoYes
LEINHOLDER:
ADDITIONAL NOTES:
Liability quoted at $500,000 unless otherwise requested.