52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>0</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>12/21/2018</StartDate>
  <EndDate>12/26/2018</EndDate>
  <DestinationPlan>Canada</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Jose</Firstname>
    <Middlename/>
    <Lastname>Gonzalez</Lastname>
    <Age>29</Age>
    <Dob>04/10/1989</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>12/21/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>15719 East 4th Avenue</Address1>
      <Address2>68</Address2>
      <Country>United States</Country>
      <State>Washington</State>
      <City>Spokane Valley</City>
      <Postcode>99037</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>xatalantax@gmail.com</Email>
    <Phone>
      <Home>8313838263</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4000220865024323</CreditcardNumber>
      <NameonCreditcard>Jose  Gonzalez</NameonCreditcard>
      <CreditcardExpirationMonth>10</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2021</CreditcardExpirationYear>
      <CreditcardAmount>9.3</CreditcardAmount>
      <CreditcardCodeNumber>891</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>