Texaspartnersinsurance

General Information

Zip Code

First Name

Middle Initial

Last Name

Date Of Birth

Email Address

Confirm Email Address

Home Phone (with area code)

Work Phone (with area code)

Home Phone (with area code)

Fax Number (with area code)

Address

City

State

Rent or Own

If married, please answer the questions below:

Marital Status:

If married, please answer the questions below:

Spouse's First Name

If married, please answer the questions below:

Spouse's Last Name

Spouse's Date of Birth

Boat Information

Year

Make

Type of Boat

Model

Length (In feet)Feet

Purchase Price (in US Dollars)$

Purchased New or Used?

New

Used

Date Purchased

Does the purchase price include the Trailer?

Yes

Number of Motors

Engine Size(s)

Inboard or Outboard

Maximum Speed

Is boat kept in locked garage?

Intended Use for Boat

Propulsion Type

Discounts / Violations

Will Boat be rented out?

Yes

Will Boat be used for business?

Yes

Years Boating years experience?

Any accidents, violations or suspensions in the past 3 years?

Yes

Are you a member of a Boating Association?

Yes

If yes, Boat club name

Coverage Information

Bodily Injury

Property Damage

Personal Liability

Uninsured Motorist

Personal Injury Protection

Deductible Information

Vehicle 1

Vehicle 2

Vehicle 3

Vehicle 4

Comp(Theft)

Collision

Miscellaneous Information

Current Insurance Company

Expiration Date

Current Premium $

Questions or Comments to help the Agent

Texas Boat Insurance Quote Form

General Information

If married, please answer the questions below:

If married, please answer the questions below:

If married, please answer the questions below:

Boat Information

Discounts / Violations

Coverage Information

Deductible Information

Miscellaneous Information