52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>110000</MaximumLimit>
  <StartDate>08/13/2018</StartDate>
  <EndDate>10/31/2018</EndDate>
  <DestinationPlan>France</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Robert</Firstname>
    <Middlename/>
    <Lastname>Donohue</Lastname>
    <Age>31</Age>
    <Dob>12/05/1986</Dob>
    <Gender>Male</Gender>
    <SportsRider>yes</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>08/13/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>40 Redwood Tree</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>California</State>
      <City>Irvine</City>
      <Postcode>92612</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>teddonohue@yahoo.com</Email>
    <Phone>
      <Home>9493021468</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Francis Donohue</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Father</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4400667174958151</CreditcardNumber>
      <NameonCreditcard>Francis Donohue</NameonCreditcard>
      <CreditcardExpirationMonth>4</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2023</CreditcardExpirationYear>
      <CreditcardAmount>112.32</CreditcardAmount>
      <CreditcardCodeNumber>586</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>