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>08/26/2021</StartDate>
  <EndDate>08/30/2021</EndDate>
  <DestinationPlan>Turks &amp;amp; Caicos Islands</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Talia</Firstname>
    <Middlename/>
    <Lastname>Halsey</Lastname>
    <Age>30</Age>
    <Dob>08/19/1991</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>08/26/2021</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>114-35 170th Street</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>New York</State>
      <City>Jamaica</City>
      <Postcode>11434</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>taliaelise819@gmail.com</Email>
    <Phone>
      <Home>7189269214</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4347698041512224</CreditcardNumber>
      <NameonCreditcard>Talia Halsey</NameonCreditcard>
      <CreditcardExpirationMonth>6</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2026</CreditcardExpirationYear>
      <CreditcardAmount>4.7</CreditcardAmount>
      <CreditcardCodeNumber>658</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>