34.192.94.100
<?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>12/27/2018</EndDate>
  <DestinationPlan>Canada</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Elizabeth </Firstname>
    <Middlename/>
    <Lastname>Chapman</Lastname>
    <Age>38</Age>
    <Dob>02/15/1980</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>12/21/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>2196 Frederick Douglass Blvd</Address1>
      <Address2>Apt 3E</Address2>
      <Country>United States</Country>
      <State>New York</State>
      <City>New York</City>
      <Postcode>10026</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>chapmanliz45@gmail.com</Email>
    <Phone>
      <Home>6466591127</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5178057659392232</CreditcardNumber>
      <NameonCreditcard>Elizabeth   Chapman</NameonCreditcard>
      <CreditcardExpirationMonth>2</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2023</CreditcardExpirationYear>
      <CreditcardAmount>14.35</CreditcardAmount>
      <CreditcardCodeNumber>224</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>