1. Name of person reporting and telephone number:
2. Description of boat
NAME
MAKE
HULL COLOR
OTHER DISTINGUISHING MARKS
3. Number of Persons aboard
NAME
ADDRESS
NAME
ADDRESS
NAME
ADDRESS
4. Engine
TYPE
5. Safety equipment
PFDs
Flares
Food
Water
6. Radio
TYPE
7. Trip Expectations
DEPARTURE TIME
DESTINATION
8. Automobile:
LICENSE #
COLOR
9. If not returned by-
Contact the Coast Guard or-
CALL -
FLOAT PLAN
TYPE
LENGTH
STRIPE COLOR
AGE
AGE
AGE
H.P.
Mirror
EPIRB
FREQUENCIES
DATE
RETURN DATE
STATE
PARKED AT
REGISTRATION#
DECK COLOR
PHONE #
PHONE #
PHONE #
FUEL CAPACITY
Flashlight
Raft/Dinghy
FROM
NO LATER THAN
MAKE
AT-
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