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>08/21/2018</StartDate>
  <EndDate>08/28/2018</EndDate>
  <DestinationPlan>Portugal</DestinationPlan>
  <NoOfApplicants>3</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>kimberley</Firstname>
    <Middlename/>
    <Lastname>Ng</Lastname>
    <Age>14</Age>
    <Dob>04/09/2004</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
  <Applicant>
    <Firstname>Daniel</Firstname>
    <Middlename>Y</Middlename>
    <Lastname>Ng</Lastname>
    <Age>44</Age>
    <Dob>07/18/1974</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
  <Applicant>
    <Firstname>kwok</Firstname>
    <Middlename/>
    <Lastname>Cheung</Lastname>
    <Age>48</Age>
    <Dob>03/12/1970</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>08/21/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>245 E 93rd street apt22c</Address1>
      <Address2>#22C</Address2>
      <Country>United States</Country>
      <State>New York</State>
      <City>NEW YORK</City>
      <Postcode>10128</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>mail@danielng.com</Email>
    <Phone>
      <Home>6468318243</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Nancy Cheung</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147202331232718</CreditcardNumber>
      <NameonCreditcard>daniel Ng</NameonCreditcard>
      <CreditcardExpirationMonth>11</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2022</CreditcardExpirationYear>
      <CreditcardAmount>29.6</CreditcardAmount>
      <CreditcardCodeNumber>1974</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>