Need a Quote for the Operation of a UAV or Drone?
    Please Complete this Form and Someone will Contact You.
    Sorry, we are unable to assist if the UAV is used only for pleasure. The insurance company will quote only if there is some business use.

    Policyholder's Information

    If the UAV will be owned & operated by a Corporation, LLC or DBA enter that name below. If it will be owned and operated by an individual(s) reflect those names below.


    Contact Information for Person Handling Insurance


    If not provide current insurance company data (if any) below:

    Aircraft Data

    UAV/Drone #1



    Aircraft Data

    UAV/Drone #2 (if only 1 aircraft skip questions pertaining to additional aircraft by clicking here.)


    ***List additional UAVs to be quoted in the Comments section at the bottom of this survey. Be sure to give the year, make, and model.



    Area of Operations

    Insurance desired


    Pilots/Operators

    Pilot 1

    Pilot 2

    Pilot 3

    First Name

    Last Name

    Age

    FAA Pilot Certificates, if any

    Total hours piloting general aviation aircraft (not UAVs)

    Total hours piloting UAVs

    Total hours piloting this make and model aircraft

    Any accidents in the last 3 years while piloting aircraft or UAVs?
    If yes, please provide details.

    Comments

    Thank you for taking the time to complete this form.

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