52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>0</DeductibleAmount>
  <MaximumLimit>550000</MaximumLimit>
  <StartDate>05/02/2021</StartDate>
  <EndDate>05/05/2021</EndDate>
  <DestinationPlan>Zimbabwe</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Shawn</Firstname>
    <Middlename/>
    <Lastname>Walters</Lastname>
    <Age>59</Age>
    <Dob>05/06/1961</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>05/02/2021</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>716 Wilkes Street</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>Virginia</State>
      <City>Alexandria</City>
      <Postcode>22314</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>Shawnw987@aol.com</Email>
    <Phone>
      <Home>7034751962</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>The Shawn L Walters revocable living trust</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>estate</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147202408264644</CreditcardNumber>
      <NameonCreditcard>Shawn l Walters</NameonCreditcard>
      <CreditcardExpirationMonth>12</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2023</CreditcardExpirationYear>
      <CreditcardAmount>19.25</CreditcardAmount>
      <CreditcardCodeNumber>716</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>