52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>100</DeductibleAmount>
  <MaximumLimit>550000</MaximumLimit>
  <StartDate>03/02/2018</StartDate>
  <EndDate>05/10/2018</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Susana</Firstname>
    <Middlename>R</Middlename>
    <Lastname>Esclaona</Lastname>
    <Age>68</Age>
    <Dob>08/11/1949</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>03/02/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>Av. Washington. Las Fuentes</Address1>
      <Address2>Res. Paraiso Pinar. Torre A-PH3</Address2>
      <Country>Venezuela</Country>
      <State/>
      <City>Caracas, D.C.</City>
      <Postcode>1020</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>vdescalona@gmail.com</Email>
    <Phone>
      <Home>02124615410</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Veronica Duque</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Daughter</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147400161276413</CreditcardNumber>
      <NameonCreditcard>Alexi Boado</NameonCreditcard>
      <CreditcardExpirationMonth>6</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2022</CreditcardExpirationYear>
      <CreditcardAmount>589.05</CreditcardAmount>
      <CreditcardCodeNumber>202</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>