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MOTORCYCLE
BOAT OWNERS
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BUSINESS
Year:
*
Is the current owner of the watercraft the original owner?
*
Yes
No
Total Horsepower:
*
Market Value of Watercraft:
*
Would you like to insure your trailer?
*
Yes
No
Watercraft Use:
*
Pleasure
Racing/Speed Contests
Business/Commercial Use
Rented/Leased to Others
Primary Residence
Is the watercraft co-owned by someone living in a separate household?
*
Yes
No
Primary Location of Watercraft:
Year Purchased:
*
Make and Model:
*
Please continue on to the driver information form.
Any claims or violations in the last 3 years?
*
Yes
No
Have you taken an approved watercraft safety course?
Yes
No
Marital Status
*
Single
Separated
Married/Domestic Partnership
Widowed
Gender:
*
Male
Female
Date of Birth:
*
Suffix
None
Sr.
Jr.
I
II
III
Drivers
Watercraft
Full Name:
*
E-mail:
*
Driver's License Status
*
Valid
Permit
Suspended
Not Licensed
Foreign Driver's License
Years Boating Experience:
*
Thank you for filling out your information! A licensed agent will contact you within the next 24 hours. If you have any questions or concerns, please call us at (866)979-Elite.
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