ROCS Group – One Group

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Passport number
ID card number
Name
Surname
Telephone Number
Mobile Number
Workplace Telephone Number
Email address

Craft Details
Make of craft
Lenght of craft
Craft Type
Engine Make
Year
No of. engines
Engine HP
Value
Moorings
No. of years free from claims
Age of Drivers (if any, comma separated)

Claims Experience – past 5 years

Other Information
Do you have other policies through ROCS Co. Ltd or with Middlesea Insurance p.l.c?
Yes	No

Additional notes/comments

	Development House, St. Anne Street, Floriana. FRN9010	ROCS House, 19-23,Main Street, Mellieha MLH2310
	T: +356 2152 4123 F: +356 2152 3869 E: insurance@rocsgrp.com

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