PSM Ltd.

Marine Brokerage & Yacht Services

www.psm-alderney.co.uk

About you:

Your full name :...............................................................................................................................................

Address: ..........................................................................................................................................................

Post code: abcaaaaa Tel: Home : ............................Work : ......................................

E-mail address:.>..................................................................................................<

About your Vessel:

Vessels name :........................................................ Type: .............................................................................

LOA : ...............LWL : ............. Beam: .................Draught: ..................Gross Tonnage: ..............................

Construction: .................................Date built : ....................................Date you obtained it: ...................

SSR Number:....................... Local Registration No : .................Sail Number :............Hull Number :..........

Radio callsign: .............................. Engine type : ......................................HP : ..............Age : .................

Last survey date: ......./......./..........Insurance Company: ...............................................................................

Valuation : £ .............................. Insured value : £ .......................Asking Price : £ ..................................

Are you the sole owner of the vessel, YES / NO ? If no, please give details: .......................................

.......................................................................................................................................................................

Is your vessel subject to any mortgage or loan commitments, YES / NO ?

Vessel is lying: .....................................................................................................

Please list all items to be sold with the vessel:...................................................

...............................................................................................................................

Other notes: ............................................................................................................

About PSM Ltd: Your vessel may be advertised as the company deems appropriate, in any of the following mediums: Company notice boards, The Internet, Nautical publications, Channel Island publications, News papers & circulars and other marine brokers as arranged by the company. Commission will be charged at 5% of the total sale price as the sole agency. Or 7% of the total sale price, as a shared agency, subject to the companies sale of your vessel. Commission will normally be deducted on receipt of a 10% deposit from the prospective purchaser, irrespective of a successful completion of sale. Your details above will be entered on PSM Database, treated in confidence and removed at your request. PSM Ltd. disclaims any responsibility for any events as a result of mis-information given to the company or false statements on this contract.PSM Ltd. uses great care and diligence in the preparation of adverts but is not responsible or liable for any mistakes, mis-print or typographical error.

I certify that the information l have submitted is true and I agree to the terms and conditions laid out above and wish to sell my vessel. I require PSM Ltd. to act as my SOLE / JOINT Marine Broker for this sale.

Signed: ............................. Date: .................... PSM Ltd: ............................

Tel: 07781-106635 Fax: 01481-824968 E-Mail: psm.alderney @ virgin.net