34.192.94.100
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  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>05/30/2019</StartDate>
  <EndDate>06/03/2019</EndDate>
  <DestinationPlan>Spain</DestinationPlan>
  <NoOfApplicants>3</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>marlon</Firstname>
    <Middlename/>
    <Lastname>aronstam</Lastname>
    <Age>54</Age>
    <Dob>03/18/1965</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
  <Applicant>
    <Firstname>Daniel</Firstname>
    <Middlename/>
    <Lastname>Aronstam</Lastname>
    <Age>24</Age>
    <Dob>03/22/1995</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
  <Applicant>
    <Firstname>greg</Firstname>
    <Middlename/>
    <Lastname>aronstam</Lastname>
    <Age>18</Age>
    <Dob>12/18/2000</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>05/30/2019</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>17626 middlebrook way</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>Florida</State>
      <City>BOCA RATON</City>
      <Postcode>33487</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>marlon@chilla.com</Email>
    <Phone>
      <Home>5618096140</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>karen aronstam</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Discover</CreditcardType>
      <CreditcardNumber>6011208890016481</CreditcardNumber>
      <NameonCreditcard>karen aronstam</NameonCreditcard>
      <CreditcardExpirationMonth>1</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2023</CreditcardExpirationYear>
      <CreditcardAmount>20.6</CreditcardAmount>
      <CreditcardCodeNumber>594</CreditcardCodeNumber>
    </Creditcard>
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