Inland Marine Change Request Form

Members that maintain Inland Marine (IM) coverage through the North Carolina School Boards Trust (NCSBT) must submit this form to make any change to the Member’s IM schedule on file with NCSBT. The form allows a Member to add new property to its IM schedule or delete previously scheduled property that the Member no longer wishes to cover. If you have any questions about this form, please contact Melody Coons at mcoons@ncsba.org or 919-747-6684.

To access the sections of this form, select the down arrow beside the headings below.

IM Change Request

Submitter

Item of Covered Property

Computer Equipment 01

Computer Equipment 02

Computer Equipment

Drone 01

Drone 02

Drone

Video/Camera Equipment

Band Equipment

Other Equipment

(Identify category/type of any other scheduled equipment)

Tools

Radio Equipment

Farm Machinery

Additional Comments

Christina MillerInland Marine Change Request Form