52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>500</DeductibleAmount>
  <MaximumLimit>110000</MaximumLimit>
  <StartDate>01/07/2020</StartDate>
  <EndDate>02/01/2020</EndDate>
  <DestinationPlan>Canada</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Aravel</Firstname>
    <Middlename/>
    <Lastname>Forbes</Lastname>
    <Age>55</Age>
    <Dob>05/04/1964</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>01/07/2020</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>48-324 Lo'ihi Rd</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>Hawaii</State>
      <City>Honoka'a</City>
      <Postcode>96727</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>agov@cyberdoor.com</Email>
    <Phone>
      <Home>8583443301</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Summer Strom</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Daughter</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Discover</CreditcardType>
      <CreditcardNumber>6011499474067616</CreditcardNumber>
      <NameonCreditcard>Aravel  Forbes</NameonCreditcard>
      <CreditcardExpirationMonth>9</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2021</CreditcardExpirationYear>
      <CreditcardAmount>107.17</CreditcardAmount>
      <CreditcardCodeNumber>900</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>