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>10/10/2021</StartDate>
  <EndDate>10/14/2021</EndDate>
  <DestinationPlan>Mexico</DestinationPlan>
  <NoOfApplicants>2</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>LUIS</Firstname>
    <Middlename>F</Middlename>
    <Lastname>ARAYA ARRIETA</Lastname>
    <Age>25</Age>
    <Dob>08/22/1996</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
  <Applicant>
    <Firstname>BRENDA</Firstname>
    <Middlename>I</Middlename>
    <Lastname>RODRIGUEZ MAROTO</Lastname>
    <Age>27</Age>
    <Dob>04/12/1994</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>10/10/2021</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>COSTA RICA, ALAJUELA, LA GARITA</Address1>
      <Address2>DULCE NOMBRE 150 N DE LA ESCUELA</Address2>
      <Country>Costa Rica</Country>
      <State/>
      <City>ALAJUELA</City>
      <Postcode>20101</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>LUISFERARRIETA2296@HOTMAIL.COM</Email>
    <Phone>
      <Home>50671073566</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>CARMEN ARRIETA GONZALEZ</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Mother</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5303152016321632</CreditcardNumber>
      <NameonCreditcard>LUIS ARAYA ARRIETA</NameonCreditcard>
      <CreditcardExpirationMonth>7</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2022</CreditcardExpirationYear>
      <CreditcardAmount>7.6</CreditcardAmount>
      <CreditcardCodeNumber>297</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>