Forbes Glider Motorglider Proposal Form

Proposer Details

Name Email Occupation
Street/Area Postal Town Post Code

Proposer Contact Details

Landline Mobile

Owner Details (if different to proposer)

Owner Name Email Contact
Street/Area Postal Town Post Code

Aircraft Details

Aircraft Manufacturer & Type Pure Glider, Turbo or Self Launch Engine Type (if fitted)
MTOM (Kg) Number of Passenger Seats U/C Type Fixed/Retractable
Registration Serial Number Year of Manufacture

Aircraft & Trailer Values

Aircraft Value
(including all fixed instruments, radio, headsets and other permanently fitted items)
Trailer Value

Ancillary Item Values

Parachute Value Non Fixed Items Value
(GPS, PDAs, Loggers etc)

Details Of Pilots To Fly This Aircraft

Number of pilots Pilot Names & Ages (6 pilots or less)

Qualifications/Hours of least Experienced Pilot to fly this Aircraft

Glider Hours Fixed Wing Hours 3 Axis Microlight Hours
Licence Type (if applicable) Hours on Type insured Hours on Similar Types

Cover Required

Cover Start & End Dates (all dates in format dd/mm/yy) Full Flight Risk Start and End Dates Ground Risk Start & End Dates

Aircraft Uses (Your Demands and Needs)

Private Club Instruction (schooling) Display/Competition Aerobatics (if yes specify in further notes) Towing Gliders (SLMG e.g. Rotax Falke Grob109) Rated/Non Rated Competitions (automatically covered) Others (describe in comments field)

Aircraft Passenger & Third Party Liability

Legal Limit of Liability Will Be Quoted i if higher limit please state below

Important Additional Information About The Aircraft

Aircraft Base/Hangared Area of Operation (if outside Europe state specific countries) Any outstanding finance on Aircraft
Current Premium/CurrentBroker No Claims Discount Amount No Claims Discount Percentage
Losses/Claims in last 5 years, if yes please provide details in further notes Do you have any other insurances you would like a quote on? If so provide details Has insured ever been declined insurance
Further Notes
 
By submitting this proposal I hereby declare that to the best of my knowledge and belief that the answers to the foregoing questions are true and complete and that I have not withheld any information which might influence the decision of the insurers with regard to this proposal. I agree that this proposal and declaration shall be the basis of the Contract between myself and the insurers if a policy is issued.

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