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>09/21/2018</StartDate>
  <EndDate>10/10/2018</EndDate>
  <DestinationPlan>Netherlands</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>elisa</Firstname>
    <Middlename>M</Middlename>
    <Lastname>LI</Lastname>
    <Age>51</Age>
    <Dob>05/13/1967</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>09/21/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>Rua Aliança Liberal</Address1>
      <Address2>1015, Ap 102, Bl Orta</Address2>
      <Country>Brazil</Country>
      <State/>
      <City>São Paulo</City>
      <Postcode>05088-000</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>elisa.liu@spl.com.br</Email>
    <Phone>
      <Home>5511981183125</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Danielle Liu Krippner</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Daughter</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5148680374430701</CreditcardNumber>
      <NameonCreditcard>elisa liu man li</NameonCreditcard>
      <CreditcardExpirationMonth>11</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2025</CreditcardExpirationYear>
      <CreditcardAmount>52.0</CreditcardAmount>
      <CreditcardCodeNumber>557</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>