52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>0</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>07/21/2021</StartDate>
  <EndDate>08/27/2021</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Etel</Firstname>
    <Middlename>H</Middlename>
    <Lastname>Langner</Lastname>
    <Age>18</Age>
    <Dob>08/12/2002</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>07/21/2021</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>19A Tcelet Mordechai ST</Address1>
      <Address2>Apt 1</Address2>
      <Country>Israel</Country>
      <State/>
      <City>Jerusalem</City>
      <Postcode>9436949</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>rllangner@gmail.com</Email>
    <Phone>
      <Home>97225003604</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Reuven Langner</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Father</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4559541800483166</CreditcardNumber>
      <NameonCreditcard>Reuven Langner</NameonCreditcard>
      <CreditcardExpirationMonth>5</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2025</CreditcardExpirationYear>
      <CreditcardAmount>58.9</CreditcardAmount>
      <CreditcardCodeNumber>964</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>