| Agent | Head Office | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | BT0001 | ||||||||
| Effective Date | 03/25/2018 | ||||||||
| Expiry Date | 04/05/2018 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | MARIA ROZAH KAITANO | ||||||||
| Policy Number | O14 | ||||||||
| Country of Origin | Malawi | ||||||||
| Destination Area | ISRAEL | ||||||||
| Address | Malawi Telecomms Limited | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | K50,468.59 | ||||||||
| Total Premium (After Tax) | K50,468.59 | ||||||||
| Signed by |
