Personal Information

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 __________________________________________________________________________________________________________

Bonus (check one) for qualified tournaments only, see www.tritonboats.com 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 tritonboats.com. 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 tritonboats.com 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.

Triton Gold Claim FormPlease print all information (except signatures)

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