34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>05/26/2019</StartDate>
  <EndDate>08/12/2019</EndDate>
  <DestinationPlan>Palestinian Territory</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Eli</Firstname>
    <Middlename/>
    <Lastname>Zaritt</Lastname>
    <Age>33</Age>
    <Dob>12/27/1985</Dob>
    <Gender>Male</Gender>
    <SportsRider>yes</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>05/26/2019</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>Haråsgatan 7</Address1>
      <Address2>Unit 1302</Address2>
      <Country>Sweden</Country>
      <State/>
      <City>Gothenburg</City>
      <Postcode>41462</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>Ezaritt@gmail.com</Email>
    <Phone>
      <Home>0721888874</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Irene Chiu</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Significant other</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147202348945211</CreditcardNumber>
      <NameonCreditcard>Eli N Zaritt</NameonCreditcard>
      <CreditcardExpirationMonth>4</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2021</CreditcardExpirationYear>
      <CreditcardAmount>92.43</CreditcardAmount>
      <CreditcardCodeNumber>619</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>