Aircraft Renter: _______________________________
Address: ___________________________________
___________________________________________
Check One:
______ Renter ("I" hereafter) understands that the hull insurance
policies, listed on the Rental Insurance Disclosure Notification Form,
provide limited coverage. Therefore, I have secured complete coverage
through a personal insurance policy which is attached to this form.
______ Renter ("I" hereafter) understands that, under the
hull insurance policies listed on the Rental Insurance Disclosure Notification
Form, I am responsible for the first $1000.00 of damage incurred by
the Aircraft. I will not be covered by a personal insurance policy,
and I am prepared to pay the amounts written above should an accident
occur.
1. The attatchment to this form contains important information about
insurance coverage. I, Renter, have read and understand that information.
Aircraft Renter's Signature:_______________________________
Date: _______________________________
Witness: _______________________________
Date: _______________________________
