Proposer's Name

Address

Business or Occupation

AIRFRAME

Make, Type & Series Number

Year of
Construction

Passenger Seating Capacity

Identification Marks

Value

1.

Purposes for which the Aircraft will be used

2.

Where will the Aircraft usually be kept?

3.

Please state the maintenance schemes of the aircrafts? And who will be responsible for the carry out of the scheme?

4.

Who will fly the Aircraft?

Name

Age

Types of Aircraft Flown

Flying Hours
Total

Make & Model

Type of License

Accidents (if any) during
last five years
(If Y provide details)

Y/N

Y/N

Y/N

Y/N

Y/N

5.

The Routes which the aircraft usually serve?

6.

What is the limit of deductible required for Hull ?

7.

Liability Limit Required: US$

8.

Please state if there is any previous losses and brief of the losses (How, value…..)