34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>1100000</MaximumLimit>
  <StartDate>09/30/2018</StartDate>
  <EndDate>11/30/2018</EndDate>
  <DestinationPlan>Indonesia</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Chaweon</Firstname>
    <Middlename/>
    <Lastname>Koo</Lastname>
    <Age>39</Age>
    <Dob>02/16/1979</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>09/30/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>11804 Filly Lane</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>Maryland</State>
      <City>Gaithersburg</City>
      <Postcode>20878</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>chaweonkoo@gmail.com</Email>
    <Phone>
      <Home>2402588567</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5178057864972687</CreditcardNumber>
      <NameonCreditcard>Chaweon  Koo</NameonCreditcard>
      <CreditcardExpirationMonth>1</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>85.56</CreditcardAmount>
      <CreditcardCodeNumber>390</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>