CLAIM

Forestay Fitting - 517-914

Please fill in all fields as accurately as possible. Fields marked with (*) are mandatory.

Boat information		Location of Mast-ID
Boat model: *
Boat ID-number: *
Mast ID-number: *
Home port: *
Current location: *
Total sailed distance: *	naut. miles
Chartered: *

Contact information
Boat owner: *
Delivery address: *
Phone: *
Alt. phone:
E-mail: *
Fax:

Alternative contact
Name:
Phone:
Alt. phone:
E-mail:

Answer question:	2 + 14 =