52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>550000</MaximumLimit>
  <StartDate>08/09/2018</StartDate>
  <EndDate>08/16/2018</EndDate>
  <DestinationPlan>Denmark</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>wei</Firstname>
    <Middlename/>
    <Lastname>Yang Krivak</Lastname>
    <Age>54</Age>
    <Dob>10/02/1963</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>08/09/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>1962 coral heights ct</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>Florida</State>
      <City>oakland park</City>
      <Postcode>33308</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>weiyang22@hotmail.com</Email>
    <Phone>
      <Home>7863020827</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>helen yang</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Sister</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4400665189325416</CreditcardNumber>
      <NameonCreditcard>wei  Yang Krivak</NameonCreditcard>
      <CreditcardExpirationMonth>10</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2025</CreditcardExpirationYear>
      <CreditcardAmount>24.64</CreditcardAmount>
      <CreditcardCodeNumber>748</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>