52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>0</DeductibleAmount>
  <MaximumLimit>550000</MaximumLimit>
  <StartDate>02/10/2020</StartDate>
  <EndDate>02/14/2020</EndDate>
  <DestinationPlan>Germany</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Curtis</Firstname>
    <Middlename/>
    <Lastname>Large</Lastname>
    <Age>50</Age>
    <Dob>12/31/1969</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>02/10/2020</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>3509 Macomb Street NW</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>Dist. of Columbia</State>
      <City>Washington</City>
      <Postcode>20016</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>achl32@yahoo.com</Email>
    <Phone>
      <Home>2024227665</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Anne Large</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4270829063537218</CreditcardNumber>
      <NameonCreditcard>Anne C Large</NameonCreditcard>
      <CreditcardExpirationMonth>2</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2021</CreditcardExpirationYear>
      <CreditcardAmount>19.25</CreditcardAmount>
      <CreditcardCodeNumber>393</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>