Transcription of BOAT HULL NO: WATERCRAFT APPLICATION
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BOAT HULL NO: WATERCRAFT APPLICATION
ACORD 82 (2013/09)CIVIL UNION (if applicable) boat hull NO:HEATING# OF EXTINGUISHERSDATE LAST WEIGHEDSIZEDESCRIPTIONTYPEY/NEQUIPMENT TYPE# OF STOVES:FUEL TYPE:SPACES PROTECTED:MODELLIMITSERIAL NUMBERMODELMANUFACTURERYEAREQUIPMENTPORT ABLE ACCESSORIES AND LIFEBOATS / TENDERSMANUFACTURERRATING / UNDERWRITINGCOOKING STOVEFUME DETECTORAUTOMATIC?2CO / CHEMICAL SYSTEMSFIRE EXTINGUISHERSBILGE PUMPSDEPTH SOUNDERRADARRADIO DIRECTION FINDERSHIP TO SHORE RADIOANTI -THEFT DEVICESY/NEQUIPMENT TYPEThis field may not be utilized forpolicyholders applying for residentialproperty insurance in CA.*MARITAL STATUS * /BIRTH DATECO-APPLICANT'S OCCUPATION (State Nature of Business if Self-Employed)APPLICANT'S OCCUPATION (State Nature of Business if Self-Employed)SECONDARY E-MAIL ADDRESS:PRIMARY E-MAIL ADDRESS:PHONE #CELLHOMEBUSPRIMARYPHONE #SECONDARYCELLHOMEBUSDATE AT CURRENT RESIDENCE:APPLICANT'S NAME A
acord 82 (2013/09) * marital status / civil union (if applicable) # explanation 2.any operator undergoing a course of treatment for a physical / mental impairment?
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