52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>0</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>12/05/2019</StartDate>
  <EndDate>12/29/2019</EndDate>
  <DestinationPlan>Cambodia</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>JINLONG</Firstname>
    <Middlename/>
    <Lastname>BAE</Lastname>
    <Age>47</Age>
    <Dob>11/05/1972</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>12/05/2019</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>8-3,nO 10,CHANGANG BUKHONG DISTRICT </Address1>
      <Address2>JILIN PROVINC</Address2>
      <Country>China</Country>
      <State/>
      <City>JILIN CITY</City>
      <Postcode>13200</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>jeo550105@gmail.com</Email>
    <Phone>
      <Home>15584071969</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>BAI, JUNMING</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Child</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5110430012616509</CreditcardNumber>
      <NameonCreditcard>JINLONG  BAE</NameonCreditcard>
      <CreditcardExpirationMonth>12</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2024</CreditcardExpirationYear>
      <CreditcardAmount>46.88</CreditcardAmount>
      <CreditcardCodeNumber>541</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>