Forbes Rotary Wing 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 Make(Type) Aircraft Model(Variant) Number of Engines Engine Type
MTOM (Kg) Number of Passenger Seats U/C Type Fixed/Retractable
Registration Serial Number Year of Manufacture

Aircraft Value

Aircraft Value (include fixed instruments)

Ancillary Item Values

Headsets Value Other Items Value (please specify)

Details Of Pilots To Fly This Aircraft

Number of pilots Pilot Names & Ages (10 pilots or less)

Qualifications/Hours of least Experienced Pilot to fly this Aircraft

Rotary Wing Hours Hours on Type Turbine Hours
Hours on Similar Types Licence Type Annual Hours Use

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

Your Demands and Needs

Private & Pleasure Taxy Flights Air Freight Industrial Aid (Business Related Flights) PPL Schooling Training for Higher Certificates
Scenic Flights Photography Below 1000ft AGL Competition Flight Dealer/Demonstration Flights Line Inspections Below 1000ft AGL Air Displays 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/Current Current Premium/Current No Claims Discount Amount No Claims Discount Percentage
Losses/Claims in last 5 years, if yes 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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