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Boat Details

Personal Details

Summary

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Company

Title*

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First Name*

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Last Name*

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Street and House Number*

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Address Add-On

ZIP Code*

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City*

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Country*

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Telephone*

Email*

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Date of Birth*

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Nationality

Ultimate Beneficial Owner (To be completed only if the policyholder is a legal entity)

First Name

Last Name

Date of Birth

Nationality

Are you a member of:

Cruising Club der Schweiz CCS

Schweizerischer Schleusenschiffer Klub SSK

schleusenverein.ch

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Summary

Boat Details

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Boat Name

Year built

Type/Manufacturer

Measurements

Hull Material

Mast Material

Sail Area (qm)

Motor Type

Engine Power (KW/HP)

Flag/ Country of registration

Cruising Area

Private use only

Yes No

Bareboat Charter

Yes No

Skipper Charter

Yes No

Value of the Yacht

Trailer

Outboard Engine

Dinghy with Outboard Engine

Personal Effects

Total insured value

The values entered above are

net (without VAT) gross

Previous Insurer

Previous Claims

Will the yacht be leased?

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At which lessor?

Personal Details

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Title

First Name

Last Name

Company

Street and House Number

Address Add-On

ZIP Code

City

Country

Telephone

Date of Birth

Nationality

Are you a member of:

Ultimate Beneficial Owner

First Name

Last Name

Date of Birth

Nationality

Desired start date of Insurance*

Recommended by

Name of company

Additional Comments:

Your Message

Legal information and data protection details:

I/We hereby confirm that the information I/we have provided is truthful, accurate and complete.*

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More information about Pantaenius can be found at: https://www.pantaenius.ch/imprint/. Current information on the processing of personal data required by art. 13 and 14 RODO can be found under: https://www.pantaenius.ch/privacy-policy/