54.173.37.134
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>550000</MaximumLimit>
  <StartDate>03/04/2016</StartDate>
  <EndDate>03/07/2016</EndDate>
  <DestinationPlan>Canada</DestinationPlan>
  <NoOfApplicants>2</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Leonel</Firstname>
    <Middlename/>
    <Lastname>Tarectecan</Lastname>
    <Age>33</Age>
    <Dob>10/22/1982</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
  <Applicant>
    <Firstname>Katia</Firstname>
    <Middlename/>
    <Lastname>Mendez</Lastname>
    <Age>28</Age>
    <Dob>09/20/1987</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>03/04/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>3241 Royal Ave</Address1>
      <Address2>Apt 2C</Address2>
      <Country>United States</Country>
      <State>New York</State>
      <City>Oceanside</City>
      <Postcode>11572</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>leonel.tarectecan@gmail.com</Email>
    <Phone>
      <Home>9177152320</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4266841381193851</CreditcardNumber>
      <NameonCreditcard>Leonel Tarectecan</NameonCreditcard>
      <CreditcardExpirationMonth>3</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2018</CreditcardExpirationYear>
      <CreditcardAmount>25.1</CreditcardAmount>
      <CreditcardCodeNumber>053</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>