52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>0</DeductibleAmount>
  <MaximumLimit>1100000</MaximumLimit>
  <StartDate>09/19/2019</StartDate>
  <EndDate>09/22/2019</EndDate>
  <DestinationPlan>Colombia</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>MESUNG</Firstname>
    <Middlename>K</Middlename>
    <Lastname>BAE</Lastname>
    <Age>45</Age>
    <Dob>10/19/1973</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>09/19/2019</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>258 BROAD AVE</Address1>
      <Address2>APT 6A</Address2>
      <Country>United States</Country>
      <State>New Jersey</State>
      <City>LEONIA</City>
      <Postcode>07605</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>M6225S@HOTMAIL.COM</Email>
    <Phone>
      <Home>2016940393</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>JAMIE J BAE</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Son</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4311963125884192</CreditcardNumber>
      <NameonCreditcard>MESUNG  K BAE</NameonCreditcard>
      <CreditcardExpirationMonth>10</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2020</CreditcardExpirationYear>
      <CreditcardAmount>12.5</CreditcardAmount>
      <CreditcardCodeNumber>996</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>