Mexico Aviation Insurance
(formerly provided by Harry M. Jannette International, L.L.C.)

MAXIMUM LIMITS OFFERED TO COMPLY WITH NEW FEDERAL LAW ENACTED IN MEXICO.

Liability Only
Limits of $184,245/$365,755
Property Damage Liability
Bodily Injury Liability
(Pilot, Crew & Passengers Excluded)

ALL Fields are required for a quote. This is an ANNUAL POLICY ONLY.
Effective March 2, 2009, we are no longer offering daily or monthly policies.  You MUST issue an annual policy only.


Issue Policy?

Effective Date (MM/DD/YYYY): 12:00 a.m. - Expiration Date: 11:59 p.m.
Name of Insured (Required):
Application completed by:  

Address of Insured:
City:   State:   Zipcode:
Email Address (Required):    

Additional Email:
Phone Number:  

U.S. Insurance Company:
Citizenship:

Pilot's Name:   Pilot's License #:     
Pilot's Date of Birth:


Policy Information

Aircraft Make:   Aircraft Model:   HP or Thrust of Aircraft:
Year:    Body Type:
Engine Make:   Number of Engines

Hull Value:    Weight in lbs (enter only numbers):
Official License No. (N-Number):    Serial Number:
Number of Seats:   Passenger:   Crew:
Base Airport:    Number of flights to Mexico:
Aircraft Use:  

Premium: $

Payment options - If you are having us issue a policy, you must complete the payment information completely.
* Upon issuance, Policy & Placement Fees are fully earned, unless original policy is returned before effective date.


Premium must accompany this application. Credit Card information, Check, or Money Order should be forwarded with completed application if coverage is desired. A policy will be returned to you immediately. When applying for coverage, PLEASE allow ample time for return of policy. The actual policy form should accompany the aircraft into Mexico. Please let us hear from you if we may be of service.

Choose the payment option you prefer:

Enter Credit Card Information Below - Enter your information in the fields below. Your information is submitted through our secure form.
Check or Money Order - Submit the application and we will contact you with the premium. You may then either come by our office or mail a money order for the amount. You will have an opportunity to print your results after you submit the application, please do so and mail a copy along with your payment.
Mail, Fax or Call in Credit Card Information - If you prefer, you may send the following information by mail, fax or you may call it in at 800-231-3988. If you mail or fax your credit card information, you will have an opportunity to print your results after you submit the application, please do so and send along with your payment.

Mail: 8131 LBJ Freeway                                  Fax 972-699-9850
          Suite 220
          Dallas, TX  75251




Cardholder name:
Credit card billing address:
City State Zip Code

Credit Card
Credit Card #:
Exp Date:

Mail Policy To:
Street Address:
City/State/Zip:  
Bill Premium To:   Same as Mailing Address
Street Address:
City/State/Zip:  

We appreciate you giving us the opportunity to service your Mexican Aviation Insurance needs.

                                                       Independent Agent    


8131 LBJ Freeway, Suite 220  |   Dallas, TX  75251  |   972.783.4915   |   fax 972.699.9850  |  


©1999 Wood-Wilson Company, Inc.