| Agent | Rennies Travel |
|---|
| Agent Code | LL016 |
|---|
| Effective Date | 09/25/2017 |
|---|
| Expiry Date | 09/29/2017 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | THOKOZANI JUSTINE GALAFFA |
|---|
| Policy Number | T/RT317 |
|---|
| Country of Origin | MALAWI |
|---|
| Destination Area | EUROPE |
|---|
| Address | Rennies Travel
P.o Box 31335
ADL House
LILONGWE
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| THOKOZANI JUSTINE GALAFFA |
MA168623 |
27 |
25,121.25 |
|
|---|
| Net Premium (Before Tax) | 25,121.25 |
|---|
| Service Fees | 15000.00 |
|---|
| Total Premium (After Tax) | 29,266.26 |
|---|
| Signed by |  |
|---|
