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Triton Gold Claim Form Personal Information

Please print all information (except signatures)

Full name ____________________________________________________________________________________________________________________ Address _ ____________________________________________________________________________________________________________________ City _ _______________________________________________________ State _ _____________________________ Zip _ ________________________ E-mail Address _______________________________________________________________________________________________________________ Phone (Day) _________________________________ (Evening) _________________________________ (Cell) _________________________________ SS# ________________________________________________________ Signature ______________________________________________________

Boat Information Boat model # ___________________________________________ Boat Serial Number ___________________________________________________ Purchase new, if so, dealer name _____________________________________________________________________________________________ Purchase used, must be registered in claim applicant’s name. Engine model # _______________________________________________ Engine serial # _ _______________________________________________ Trolling motor model #* __________________________________ Trolling motor serial # _________________________________________________ *must be a MotorGuide to qualify for Black Gold

Tournament Information Tournament Name _____________________________________________________ Tournament Date ______________________________________ Tournament Location - City __________________________________________ State _______________ Lake ________________________________ Tournament web site address_ _________________________________________________________________________________________________ Director’s name _ _______________________________________________ Director’s phone number ______________________________________ Director’s signature ___________________________________________________________________________________________________________


(check one) for qualified tournaments only, see for details(1)

 $5,000 Black Gold Bonus(2) __________________________________________________________________________________________________  $500 Standard Triton Gold Tournament win 30-59 boats ________________________________________________________________________  $1,000 Standard Triton Gold tournament win 60 or more boats ____________________________________________________________________________________________  $3,000 B.A.S.S. Open – win __________________________________________________________________________________________________  $3,000 Pro Series win – 60 or more boats _____________________________________________________________________________________  $1,500 B.A.S.S. Open – highest placing(3) _ ____________________________________________________________________________________  $2,000 Triton-sponsored Championship – win _________________________________________________________________________________  $1,000 Triton-sponsored Championship – highest placing(3) _____________________________________________________________________  $2,000 Mercury ProXS bonus ________________________________________________________________________________________________  Other Qualifying Finish ______________________________________________________________________________________________________ Triton Gold claim forms must be submitted within 30 days of eligible tournament win. Additional claim forms are available at Triton Boats dealerships. Completed claim form must be accompanied by some form of official tournament results verification (ex. newsletter/magazine listing, web site results printout, or original hard-copy) depicting Triton owner’s first place/top overall finish and a participating field of 30 or more boats. Please allow 6-8 weeks for approval and processing. Winning Triton retail owner is solely responsible for submitting the completed claim form and accompanying tournament results verification to: Triton Gold Headquarters, 15 Bluegrass Drive, Ashland City, TN 37015 For additional Triton Gold information, visit our web site at To speak to a Triton Gold representative, phone 1-615-792-6767 Triton Gold headquarters reserves the right to determine final retail owner bonus eligibility for all claims.

Black Gold: Rules and Disclaimer

All Triton Gold rules and requirements must be met to be qualified for any bonus program. If your Triton Boat is NOT a 2006-2008 model year boat, Triton Gold Rules and bonuses will still apply. See or call toll free 1-888-887-4866 for Triton Gold rules. (1) Triton Gold Members only.(2) The Black-Gold Weekend Series Bonus represents the total bonus program in affect for the 2008 tournament year and supersedes all other bonus programs offered from Mercury, Triton and MotorGuide. No other bonus programs will apply. (3) In-lieu of a Triton (first place) Winner. Triton Boats, Mercury Marine, MotorGuide and the ABA, reserve the right to make changes in the rules, payout schedule and bonus programs at anytime without prior notice.

Return to: Triton Gold Headquarters, 15 Bluegrass Dr., Ashland City, TN 37015

Triton Gold Claim Form  

Return to: Triton Gold Headquarters, 15 Bluegrass Dr., Ashland City, TN 37015  $1,000 Standard Triton Gold tournament win 60 or more boats...

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