Add An Aircraft

Disclaimer: Any changes requested on this website are NOT official until you receive written confirmation from Regal Aviation Insurance.

*required fields

Requester Information

*Name of person making request:

*Email of person making request:

*Phone # of person making request:

Policy Information

*Named Insured:

*Policy Number:

*Date you would like the aircraft added:

Aircraft

*Aircraft Registration Number:

*Aircraft Year:

*Aircraft Make:

*Aircraft Model:

*Number of Seats in the Aircraft:

*Base Airport Identifier:

*Base Airport City:

*Base Airport State:

*Insured Value:

*Liability Limit:

Pilots

*Number of Pilots to Fly Aircraft:

*Are these pilots Named on your policy now?

*If the above answer is "no", please complete a Pilot History Form for every pilot you wish to have fly the aircraft.

Pilot Name:
Pilot Make & Model Time:

2nd Pilot Name:
2nd Pilot Make & Model Time:

3rd Pilot Name:
3rd Pilot Make & Model Time:

4th Pilot Name:
4th Pilot Make & Model Time:

5th Pilot Name:
5th Pilot Make & Model Time:

6th Pilot Name:
6th Pilot Make & Model Time:

7th Pilot Name:
7th Pilot Make & Model Time:

8th Pilot Name:
8th Pilot Make & Model Time:

9th Pilot Name:
9th Pilot Make & Model Time:

Notes:

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