Incident Details

What happened?(Required)

Value of charter fee you are requesting be refunded(Required)

Vessel Name(Required)

Incident date(Required)

Document Uploads

If you have been given a passcode please enter it here

A copy of the yacht charter agreement(Required)

Drop files here or

Accepted file types: jpg, png, pdf, txt, doc, docx, dot, dotx, jpeg, Max. file size: 10 MB, Max. files: 5.

Receipts for instalments paid to the charter company(Required)

Drop files here or

Accepted file types: jpg, png, pdf, txt, doc, docx, dot, dotx, jpeg, Max. file size: 10 MB, Max. files: 5.

Doctor’s certificate or hospital letter confirming the dates and nature of your incapacity/illness.(Required)

Drop files here or

Accepted file types: jpg, png, pdf, txt, doc, docx, dot, dotx, jpeg, Max. file size: 10 MB, Max. files: 3.

Death certificate, order of service or obituary notice(Required)

Drop files here or

Accepted file types: jpg, png, pdf, txt, doc, docx, dot, dotx, jpeg, Max. file size: 10 MB, Max. files: 3.

Official armed forces document(Required)

Drop files here or

Accepted file types: jpg, png, pdf, txt, doc, docx, dot, dotx, jpeg, Max. file size: 10 MB, Max. files: 3.

Loss adjuster's report or report from the emergency services which clarifies the nature and extent of the damage.(Required)

Drop files here or

Accepted file types: jpg, png, pdf, txt, doc, docx, dot, dotx, jpeg, Max. file size: 10 MB, Max. files: 3.

Your summons for jury service/court witness(Required)

Drop files here or

Accepted file types: jpg, png, pdf, txt, doc, docx, dot, dotx, jpeg, Max. file size: 10 MB, Max. files: 3.

Please upload any other photos/documents which maybe useful

Drop files here or

Accepted file types: jpg, png, pdf, txt, doc, docx, dot, dotx, jpeg, Max. file size: 10 MB, Max. files: 5.

Confirmation from a government office detailing the Adverse Weather or web links from a reputable national news outlet(Required)

Please provide further details

Charter Details

Charter Agency you purchased the guarantee from(Required)

Date purchased(Required)

Charter start date(Required)

Charter end date(Required)

Your Details

First Name(Required)

Last Name(Required)

Address(Required)

Town/City(Required)

US States(Required)

Postcode/Zip(Required)

Country(Required)

Mobile Phone(Required)

Payment

Please ensure your bank details are correct. We can not refund the card you purchased with as we are a third party refunds service and do not hold your original purchase information. All bank data is encrypted and securely managed.

Payment

Credit Union Accounts can not receive refunds, please do not supply details for this kind of account or your refund will be rejected by your bank.

Please ensure your bank details are correct. We can not refund the card you purchased with as we are a third party refunds service and do not hold your original purchase information. All bank data is encrypted and securely managed.

Payment

Please ensure your Sort Code and Account Number are correct. We can not refund the card you purchased with as we are a third party refund service and do not hold your original purchase information. All bank data is encrypted and securely managed.

Name as it appears on your bank account(Required)