LNMC Rental Boat Application

Rental Boat Permit Application
Type a question
I, the undersigned, agree to abide by all federal, state, and local regulations, including the Lake Norman Marine Commission Rental Boat Regulations.

I also acknowledge that if I violate the Lake Norman Marine Commission Rental Boat Regulations, provide any false information on the Rental Boat application and associated supporting documents, or are involved in any illegal activity associated with the boats being rented, my Rental Boat Permit will be subject to revocation by the Lake Norman Marine Commission.

Note, you must sign the form below before submitting this application.
Rental Company Information
Name of Rental Boat Company*
Company Address*

Street Address

Address Line 2

CityState / Province

Postal / Zip Code
Owner's Information
Owner's Name*

First NameLast Name
Phone number*
Email
example@example.com
Insurance Information
Name of Insured*

First NameLast Name
Address of Insured*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Insurer*

First NameLast Name
Address of Insurer*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Effective Dates*

MonthDayYear
Date
Policy Number*
Ins. Co. Phone*
Liability Limits*
(minimum $500,000)
Please attached proof of insurance policy.*

Must be in PDF format
Cancelof
List of Vessels Insured*
Safety Inspection Information
Attached copies of each vessels completed Safety Inspection Form.*

Must be in PDF format
Cancelof
Signature

The undersigned, acknowledge that the above information is true and accurate to the best of my knowledge.
Name*

First NameLast Name
Sign*

Clear
Date*

MonthDayYear
Date
Registration Fees*
prevnext( X )
LNMC boat registration fee$2.00 per boat being registered.
$2.00 Quantity
Item subtotal:$0.00

Total

$0.00
Should be Empty:

Rental Boat Permit Application

Rental Company Information

Owner's Information

Insurance Information

Safety Inspection Information

Signature