Request a quote | Pantaenius Poland

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

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Date of Birth

Nationality

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Hull

Third Party Liability

Personal Accident

War, Strike and Confiscation Insurance

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Summary

Boat Details

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Boat Name

Year built

Type/Manufacturer

Measurements

Material

Mast

Sail Area (qm)

Motor Type

Engine Power (KW/HP)

Flag/ Country of registration

Cruising Area

Private use only

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Bareboat Charter

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Skipper Charter

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Value of the Yacht

Trailer

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

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Ultimate Beneficial Owner

First Name

Last Name

Date of Birth

Nationality

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Name of company

Additional Comments:

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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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I/We have taken note of the information on the pre-contractual duty of disclosure.*

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

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