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>08/31/2018</StartDate>
  <EndDate>09/22/2018</EndDate>
  <DestinationPlan>Italy</DestinationPlan>
  <NoOfApplicants>3</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Luz </Firstname>
    <Middlename>E</Middlename>
    <Lastname>Santa Gutierrez</Lastname>
    <Age>58</Age>
    <Dob>01/15/1960</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
  <Applicant>
    <Firstname>Mario</Firstname>
    <Middlename/>
    <Lastname>Zuluaga Giraldo</Lastname>
    <Age>61</Age>
    <Dob>05/24/1957</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
  <Applicant>
    <Firstname>Jesus</Firstname>
    <Middlename>G</Middlename>
    <Lastname>Santa Gutierrez</Lastname>
    <Age>59</Age>
    <Dob>01/01/1959</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>08/31/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>Carrera 24B 17 40 </Address1>
      <Address2>Casa 108</Address2>
      <Country>Colombia</Country>
      <State/>
      <City>Medellin</City>
      <Postcode>050021</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>zuluagasanta@gmail.com</Email>
    <Phone>
      <Home>573104222552</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Carlos Zuluaga Santa</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Son</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5303723918349747</CreditcardNumber>
      <NameonCreditcard>Carlos Mario Zuluaga S</NameonCreditcard>
      <CreditcardExpirationMonth>11</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2024</CreditcardExpirationYear>
      <CreditcardAmount>194.35</CreditcardAmount>
      <CreditcardCodeNumber>021</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>