Wise Insurance Boat Insurance Questionnaire

Wise Insurance Boat Insurance Questionnaire

You are making a "Wise Choice"...... Call Lacey Warden if you have any questions 863-534-3431
Driver 1*

First NameLast Name
Phone Number*
Please enter a valid phone number
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How did you hear about us?*
Date of Birth Driver 1

MonthDayYear
Drivers license of Driver 1*
Are you Married or Single?*

MarriedSingle
Hull ID*
Year*
Make*
Model*
Lenth*
Watercraft Type*
Please Select
Define "other"
Market Value INCLUDING TRAILER*
Total HP*
Number of engines*
Boat Use*

PleasureBusiness/CommercialLeased to others
Storage Location*

HomeMarinaStorage Facility
Hull Material*

FiberglassAluminumInflatableRopleneWoodSteel
Do you have another boat to be insured?*

YesNo
Year*
Hull ID*
Make*
Model*
Lenth*
Watercraft Type*
Please Select
Define "other"
Market Value INCLUDING TRAILER*
Total HP*
Number of engines*
Boat Use*

PleasureBusiness/CommercialLeased to others
Storage Location*

HomeMarinaStorage Facility
Do you currently have boaters insurance?*

Yesno
What is your Bodily Injury limits on your current Auto policy? (If Applicable ) If NONE put "NONE"*
Do you have another driver to list on the policy?*

YesNo
Driver 2*

First NameLast Name
Date of Birth Driver 2

MonthDayYear
Drivers Llicense of Driver 2*
NOT REQUIRED BUT BENIFICIAL Upload a picture of your current Declaration page for a discount, Not the ID card!

Cancelof
Do you own a home?*

YesNo
Would you like a quote on Your home for a possible additonal discount?*

YesNo
Should be Empty: