52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>0</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>01/30/2017</StartDate>
  <EndDate>01/29/2018</EndDate>
  <DestinationPlan>Germany</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Lynette</Firstname>
    <Middlename/>
    <Lastname>Kruger</Lastname>
    <Age>62</Age>
    <Dob>11/04/1954</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>01/30/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>1165 Landwehr Road</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>Illinois</State>
      <City>Northbrook</City>
      <Postcode>60062</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>lkruger@lallemand.com</Email>
    <Phone>
      <Home>8473224834</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5569070000575535</CreditcardNumber>
      <NameonCreditcard>Lynette  Kruger</NameonCreditcard>
      <CreditcardExpirationMonth>2</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2020</CreditcardExpirationYear>
      <CreditcardAmount>1482.81</CreditcardAmount>
      <CreditcardCodeNumber>130</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>