Premier Class Insurance Services, Inc.
First Tower Insurance

PERSONAL PLEASURE & BUSINESS
FIXED-WING AIRCRAFT INSURANCE SHORT FORM

If you would like a free, no obligation quote on Personal Aviation Insurance, please provide your name,
phone and fax numbers below and an application will be sent to you upon request.


Contact Name:
Mailing Address:
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PREMIER CLASS INSURANCE SERVICES, INC.
P.O. Box 7325
Orange, CA 92863-7325

PHONE:   (714) 453-0611
TOLL FREE:   (866) 441-0321
FAX:   (714) 453-0615
E-mail:   info@firsttower.com

CA Lic. #: 0D08422

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