Aviation Questionnaire

Name

This field is for validation purposes and should be left unchanged.

Life Insured's Name

Agent's Name

1. What type of Pilot’s license do you currently hold

i. Total number of hours flown

ii . Date of last flight as a pilot

iii. Date of last license renewal

Tick, whichever is appropriate

Type of Flying

Type of Aircraft

Past 12 months (No. of hrs.)

Past 12-24 months (No. of hrs.)

Contemplated Next 12 months (No. of hrs.)