TIS Old: Boat Insurance - On-line Application/Quotation Form
TIS Old: Boat Insurance - On-line Application/Quotation Form
Full Name
*
NIE Nº.
*
Email
*
Tel./Mob. Number(s)
*
Address (Spanish)
*
Post Code
*
Type of Boat
*
Boat - No Cabins
Boat - WITH cabins
Sail boat <6 meters in length
Sail boat >6 meters in length
Catamaran - with motor
Catamaran - with sails
JetSkis - WITH robbery
JetSkis - WITHOUT robbery
Use of boat
*
Private
Rented - WITHOUT crew
Rented - WITH crew
Rented - to Private crew
Registration Nº Type
*
00
6
7
Registration Number
*
Year Built
*
Length of Boat
*
Nº of Motors
*
Horse Power (Total)
*
SPEED in knots
*
NAME of boat
*
Make/Model of Boat
*
Make/Model of Engine(s)
*
Sailing Certification/License
*
No of Years Experience
*
Date of Birth
Date of Birth
*
/
DD
/
MM
YYYY
Where Moored
*
In port
Not in a port
Geographic Limits
*
No Extention - coastline
The Mediterrean - European Ports
The Mediterrean - European & African Ports
FLAG
*
SPAINISH
Other European
Value of Boat insured @...
*
New for old
Book Value
Regatas
*
Never
Along the coast
All types
Make/Model of any Auxilary Launch
In port
Not in a port
Make/Model of any Trailer
In port
Not in a port
Extra Covers/Guarantees
VALUE of boat
VALUE of Accessesories
VALUE of Personal Items
Removal of Debris
*
No
Yes
Nautical Assitance
*
No
Yes
Accidents - Captain
*
No
Yes
Accidents - Passengers
*
No
Yes
Voluntary Public Liability
*
NOT REQUIRED
163,433€
264,446€
413,433€
663,433€
Skiers Public Liability
*
No
Yes
Contamination of Water
*
No
Yes
Payment Method
Payment Method
Cash
Debit/Credit Card
Direct Debit
IBAN CODE : 24 Characters.
ESxx , plus Bank Account Nº ( 20 Digits 4-4-2-10 )
Policy MUST be paid by Direct Debit to qualify for CashBack and other offers.
Any Comments , Suggestions or Recommendations :
Start Date of Policy
Start Date of Policy
/
DD
/
MM
YYYY
Data Protection/Ley de Protección de Datos
*
Data Protection/Ley de Protección de Datos
I agree to the sending and retention of this personal data in compliance with The Data Protection Act. / Estoy de acuerdo con el envío y la retención de estos datos personales de acuerdo con la Ley de Protección de Datos.
Type the letters you see in the image below.