If you are human, leave this field blank.Marine Venture Group Boat & Yacht Insurance Quote FormFirst Name *Last Name *Primary Physical Residence *City *State *SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingZip Code *Mailing address (if different)Date of BirthDrivers License NumberHome PhoneCell *FaxEmail *Marital Status *SelectDomestic PartnershipDivorcedMarriedSingleWidowedHome Ownership Status *SelectOwn Home/CondoRentGender *SelectMaleFemaleOtherYear Built *Length of Vessel *Manufacturer *Model *Hull IDRequested Effective Date *Purchase date or financial loan closing datePurchase Price (in USD)Include taxes; title and registration feesNumber of engine(s) *Select1234Maximum Speed (mph)Horsepower each engineEngine TypeSelectInboardInboard/OutboardOutboardPod/IPS/ZeusAir PropJetHull MaterialSelectFiberglassInflatableAluminumWoodSteelOtherFuel Type *SelectGasDieselElectricHas the applicant previously owned other watercraft? *YesNoIf yes then fill in the following details.If multiple watercraft, list largest to smallest.Make(s)Length(s)Number of Years OwnedHas the applicant previously operated other watercraft? *Including family, friends and rental boats.If yes then fill in the following details.MakeLengthNumber of Years OperatingAny boating claims/losses within last five years? *YesNoIf you had a loss please provide the following details.Date of LossCause of LossNature of Loss