52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>1000</DeductibleAmount>
  <MaximumLimit>50000</MaximumLimit>
  <StartDate>02/29/2020</StartDate>
  <EndDate>03/07/2020</EndDate>
  <DestinationPlan>Canada</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Rod</Firstname>
    <Middlename/>
    <Lastname>Vasquez </Lastname>
    <Age>71</Age>
    <Dob>03/25/1948</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>02/29/2020</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>382 Anacapa Island drive </Address1>
      <Address2/>
      <Country>United States</Country>
      <State>California</State>
      <City>Camarillo </City>
      <Postcode>93013</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>phillipscaroc@gmail.com</Email>
    <Phone>
      <Home>8057967015</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Carolyn Phillips </AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5189410100156994</CreditcardNumber>
      <NameonCreditcard>Carolyn c Phillips </NameonCreditcard>
      <CreditcardExpirationMonth>2</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2024</CreditcardExpirationYear>
      <CreditcardAmount>46.08</CreditcardAmount>
      <CreditcardCodeNumber>751</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>