34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>100</DeductibleAmount>
  <MaximumLimit>550000</MaximumLimit>
  <StartDate>07/14/2017</StartDate>
  <EndDate>07/30/2017</EndDate>
  <DestinationPlan>Portugal</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Robyn</Firstname>
    <Middlename/>
    <Lastname>Blackburn</Lastname>
    <Age>42</Age>
    <Dob>03/15/1975</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>07/14/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>205 West 88th Street, Apt 15A</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>New York</State>
      <City>New York</City>
      <Postcode>10024</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>robisltdinnyc@gmail.com</Email>
    <Phone>
      <Home>9086663017</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Percy Blackburn</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Father</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4839504137042644</CreditcardNumber>
      <NameonCreditcard>Robyn  Blackburn</NameonCreditcard>
      <CreditcardExpirationMonth>10</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2020</CreditcardExpirationYear>
      <CreditcardAmount>36.65</CreditcardAmount>
      <CreditcardCodeNumber>398</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>