|
Full
name:
|
*
|
|
Date
of birth:
|
Day:Month:Year:*
|
|
Licence
issued on:
|
Day:Month:Year:*
|
|
Address
in Spain:
|
|
|
Post
code:
|
*
|
|
City:
|
|
|
Telephone:
|
*
|
|
Fax:
|
|
|
E-mail:
|
|
|
| Motor
Boat information
: |
|
Boat
name:
|
|
|
Country
of registration:
|
|
|
Type
of motor boat, make and model:
|
|
|
Construction
material:
|
|
|
Year
first registered:
|
*
|
|
Authorised no. of persons:
|
*
|
|
Speed
in knots:
|
* |
|
Length:
|
* |
|
Beam:
|
|
|
Depth:
|
|
|
Displacement:
|
|
|
Navigation
area:
|
Spanish
and French waters*
European
Mediterranean
Others. |
|
Nº
of engines:
|
Inboard
Outboard |
|
Engine
make:
|
|
|
Fuel:
|
|
|
Total
HP:
|
* |
|
Hull
value:
|
€ |
|
Engine(s)
value:
|
€ |
|
Accessories
value:
|
€
*safety
equipment and
non-standard items |
|
Value
of personal effects:
|
€
*clothes,
binoculars, photographic equipment,
fishing
rods, etc. |
|
Place
of usual mooring:
|
|
|
Auxiliary
boat:
|
Yes No |
|
Auxiliary
boat value:
|
€ |
|
Auxiliary
engine:
|
Yes
No |
|
Value
of auxiliary engine:
|
€ |
|
Boat
Trailer value:
|
€ |
|
Removal
of wreck
|
Yes
No
€ |
|
Civil
liability:
|
Yes
No
336.566,78 €
601.012.10
€
901.518,16
€
|
|
Legal
protection included:
|
Yes No |
|
Assistance
at sea:
|
Yes
No |
|
Water
skiing:
|
Yes
No |
|
Skier:
|
Yes
No
Nº |
|
Additional Information:
|
|
|
|
|
| I
would like to receive the information by: |
-
E-mail
-
Fax
-
Telephone
-
Mail
-
A personal visit from the broker
in person in Duñach’s office in Roses
in person in Duñach’s office in Empuriabrava
|