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Request Survey and/or Information Form
Date:
Name:
Address:
City:
State: Zip: Code
Phone: Day Night
Alternate Phone Number: Day Night
Email Address:
Preferred Method of Contact: PhoneEmailUS Mail
Please tell us about the boat you'd like to have surveyed:
PowerSail Diesel Gas# Engines One Two
Manufacturer:
Length: Year:
Model:
Rig: Sloop Ketch Cutter Yawl Schooner
Configuration Aft Cockpit Center Cockpit Flybridge Express Open Other
Material: Fiberglass Wood Composite Other
Type of Survey Requested: PrePurchase Insurance Donation Appraisal Appraisal Pre-Survey Inspection Other
If "Other", please indicate:
Purchase Price or Insured Value:
Where is the boat located?
Am Interested In Documentation: YESNO
Type of Documentation: Please Select A Category Change of Status Claim of Lien Documentation Removal Initial Documentation Lender Services Lien Clearance Preferred Mortgage Replace Lost Document Satisfaction of Mortgage Titling & Registration Consultations U.S. Corporate Documentation
I Would Like Information On: Please Select A Category Yacht Surveys Vessel Management Handling Instruction Maritime Project Management New Project Management Consultation Legal Witness/Expert Testimony Captain Konz Resume Type of Report of Marine Survey Other comments or questions:
I Would Like Information On: Please Select A Category Yacht Surveys Vessel Management Handling Instruction Maritime Project Management New Project Management Consultation Legal Witness/Expert Testimony Captain Konz Resume Type of Report of Marine Survey
Other comments or questions:
