34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>08/21/2019</StartDate>
  <EndDate>08/27/2019</EndDate>
  <DestinationPlan>Malaysia</DestinationPlan>
  <NoOfApplicants>4</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Josh</Firstname>
    <Middlename/>
    <Lastname>bonde</Lastname>
    <Age>19</Age>
    <Dob>05/15/2000</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
  <Applicant>
    <Firstname>Jeremiah</Firstname>
    <Middlename/>
    <Lastname>bonde</Lastname>
    <Age>22</Age>
    <Dob>02/08/1997</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
  <Applicant>
    <Firstname>Dean</Firstname>
    <Middlename/>
    <Lastname>bonde</Lastname>
    <Age>51</Age>
    <Dob>07/28/1968</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
  <Applicant>
    <Firstname>Joan</Firstname>
    <Middlename>A</Middlename>
    <Lastname>bonde</Lastname>
    <Age>50</Age>
    <Dob>12/16/1968</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>08/21/2019</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>4309 Rustic Place</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>Minnesota</State>
      <City>Shoreview</City>
      <Postcode>55126</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>deanbonde1@yahoo.com</Email>
    <Phone>
      <Home>6512462368</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>joann</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147097551742317</CreditcardNumber>
      <NameonCreditcard>DEAN BONDE</NameonCreditcard>
      <CreditcardExpirationMonth>3</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2020</CreditcardExpirationYear>
      <CreditcardAmount>47.04</CreditcardAmount>
      <CreditcardCodeNumber>852</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>