52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>05/14/2019</StartDate>
  <EndDate>05/27/2019</EndDate>
  <DestinationPlan>Russian Federation</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Vladislav</Firstname>
    <Middlename>L</Middlename>
    <Lastname>Yeganov</Lastname>
    <Age>55</Age>
    <Dob>03/03/1964</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>05/14/2019</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>4010 Gilbert ave </Address1>
      <Address2>Unit C</Address2>
      <Country>United States</Country>
      <State>Texas</State>
      <City>Dallas</City>
      <Postcode>75219</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>yeganov@sbcglobal.net</Email>
    <Phone>
      <Home>4693608468</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4320161002518442</CreditcardNumber>
      <NameonCreditcard>Vladislav L Yeganov</NameonCreditcard>
      <CreditcardExpirationMonth>4</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2020</CreditcardExpirationYear>
      <CreditcardAmount>36.4</CreditcardAmount>
      <CreditcardCodeNumber>990</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>