27.100.15.29
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    <ReferenceId>ec10cffd</ReferenceId>
    <PlanId>1</PlanId>
    <UserIp>127.0.0.8</UserIp>
    <DeductibleAmount>250</DeductibleAmount>
    <MaximumLimit>25000</MaximumLimit>
    <StartDate>09/01/2021</StartDate>
    <EndDate>09/30/2021</EndDate>
    <NoOfApplicants>2</NoOfApplicants>
    <DestinationPlan>Virgin Islands(British)</DestinationPlan>
    <PersonalInfo>
        <Applicants>
            <Applicant>
                <Firstname>Main Applicant</Firstname>
                <Middlename></Middlename>
                <Lastname>S</Lastname>
                <Dob>02/22/1957</Dob>
                <Gender>Female</Gender>
                <SportsRider>no</SportsRider>
                <PassportNumber>ABCD</PassportNumber>
            </Applicant>
            <Applicant>
                <Firstname>Dependant</Firstname>
                <Middlename></Middlename>
                <Lastname>S</Lastname>
                <Dob>02/22/1957</Dob>
                <Gender>Female</Gender>
                <SportsRider>no</SportsRider>
                <Relation>Dependent</Relation>
                <PassportNumber>EFGH</PassportNumber>
            </Applicant>
        </Applicants>
    </PersonalInfo>
    <DepartureInfo>
        <HomeCountryDepartureDate>12/13/2020</HomeCountryDepartureDate>
    </DepartureInfo>
    <ApplicantAddress>
        <MailForwardingAddress>
            <MailingName>Elfrida Borroa Kelly</MailingName>
            <Address1>Campo de Avicion Casa #19</Address1>
            <Address2></Address2>
            <Country>Dominican Republic</Country>
            <State>DR</State>
            <City>Sabana</City>
            <Postcode>25000</Postcode>
        </MailForwardingAddress>
        <ResidenceAddress>
            <Address1>Campo de Avicion Casa #19</Address1>
            <Address2></Address2>
            <Country>Dominican Republic</Country>
            <State>DR</State>
            <City>Sabana</City>
            <Postcode>25000</Postcode>
        </ResidenceAddress>
        <BillingAddress>
            <BillingAddress1>dfg</BillingAddress1>
            <BillingAddress2></BillingAddress2>
            <BillingCountry>United States</BillingCountry>
            <BillingState>FL</BillingState>
            <BillingCity>Saint Petersburg</BillingCity>
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            <Phone1>+1-8298916733</Phone1>
        </Phone>
        <Email>parth.sadatiya@radixweb.com</Email>
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    <Beneficiary>
        <AdDBeneficiaryName>XXXXXXX</AdDBeneficiaryName>
        <AdDBeneficiaryRelationship>daughter</AdDBeneficiaryRelationship>
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    <CitizenshipCountry>Dominican Republic</CitizenshipCountry>
                <PassportNumber>ABCD</PassportNumber>
    <CourierCharges>no</CourierCharges>
    <PaymentMethod>
        <CreditCard>
            <CreditcardType>MasterCard</CreditcardType>
            <CreditcardNumber>4111111111111111</CreditcardNumber>
            <Nameoncreditcard>test</Nameoncreditcard>
            <CreditcardExpirationMonth>5</CreditcardExpirationMonth>
            <CreditcardExpirationYear>2021</CreditcardExpirationYear>
            <CreditcardAmount>156.06</CreditcardAmount>
            <CreditcardCodeNumber>123</CreditcardCodeNumber>
        </CreditCard>
    </PaymentMethod>
</RegistrationXML>