54.226.34.195
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>0</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>02/25/2015</StartDate>
  <EndDate>03/23/2015</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Gloria</Firstname>
    <Middlename/>
    <Lastname>Eden</Lastname>
    <Age>61</Age>
    <Dob>01/28/1954</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>02/25/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>401 -5562 Balsam St</Address1>
      <Address2></Address2>
      <Country>Canada</Country>
      <State>British Columbia</State>
      <City>Vancouver</City>
      <Postcode>V6M4B7</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>gloriaeden@me.com</Email>
    <Phone>
      <Home>6046571008</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName></AdDBeneficiaryName>
    <AdDBeneficiaryRelationship></AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4520880023568155</CreditcardNumber>
      <NameonCreditcard>Gloria  Eden</NameonCreditcard>
      <CreditcardExpirationMonth>1</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2016</CreditcardExpirationYear>
      <CreditcardAmount>161.33</CreditcardAmount>
      <CreditcardCodeNumber>365</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>