Regal LS4C - Vessel Information Sheet

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Vessel Information Sheet
Owner: ______________________________________________________________________
Address: _____________________________________________________________________
City & State: __________________________________________________________________
Home Phone: ____________________ Business Phone: _____________________________
In Case Of Emergency Notify: ___________________________________________________
Address _____________________________________________________________________
_____________________________________________________________________________
City & State __________________________________________________________________
Phone _______________________________________________________________________
Insurance Agent’s Name: _______________________________________________________
Policy#: _____________________________________________________________________
USCG Phone: ___________________ Local Po-
lice:____________________________________
Marina Phone: _________________ Slip (Dock#): ___________________________________
Hull Serial #: RGM __ __ __ __ __ __ __ __ __
Key #:__________ Engine:_____________
Selling Dealer: ________________________________________________________________
Address: ____________________________________________________________________
City & State: _________________________________________________________________
Phone: ______________________ Fax: ___________________________________________
Servicing Dealer: ______________________________________________________________
Address:______________________________________________________________________
City & State:___________________________________________________________________
Phone:______________________ Fax:______________________________________________