| Agent | Satguru Travel | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | LLW004 | ||||||||
| Effective Date | 10/27/2017 | ||||||||
| Expiry Date | 11/06/2017 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | SADALA KAYISI M'BWANA | ||||||||
| Policy Number | Aug/27 | ||||||||
| Country of Origin | MALAWI | ||||||||
| Destination Area | Netherlands | ||||||||
| Address | LILONGWE MALAWI | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 43,674. | ||||||||
| Total Premium (After Tax) | 85,000 | ||||||||
| Signed by |
