184.72.211.106
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>09/18/2016</StartDate>
  <EndDate>01/17/2017</EndDate>
  <DestinationPlan>India</DestinationPlan>
  <NoOfApplicants>2</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Michael </Firstname>
    <Middlename>S</Middlename>
    <Lastname>Capaldo</Lastname>
    <Age>33</Age>
    <Dob>04/24/1983</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
  <Applicant>
    <Firstname>Thalita</Firstname>
    <Middlename>A</Middlename>
    <Lastname>Forray</Lastname>
    <Age>26</Age>
    <Dob>01/06/1990</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>09/18/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>Unit 2 - 2042 Bayswater street</Address1>
      <Address2/>
      <Country>Canada</Country>
      <State>British Columbia</State>
      <City>Vancouver</City>
      <Postcode>V6K4A8</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>mikecapaldo@hotmail.com</Email>
    <Phone>
      <Home>7788797370</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Christi Pope</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Mother</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4789011102153802</CreditcardNumber>
      <NameonCreditcard>Michael  Capaldo</NameonCreditcard>
      <CreditcardExpirationMonth>8</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2017</CreditcardExpirationYear>
      <CreditcardAmount>202.52</CreditcardAmount>
      <CreditcardCodeNumber>170</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>