| Agent | Falcon Travel | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | MC | ||||||||
| Effective Date | 11/07/2017 | ||||||||
| Expiry Date | 10/14/2017 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | MAGGIE NGWIRA | ||||||||
| Policy Number | FTC015 | ||||||||
| Country of Origin | Malawi | ||||||||
| Destination Area | GERMANY | ||||||||
| Address | Falcon Travel Company | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | K47,741.00 | ||||||||
| Total Premium (After Tax) | K47,741.00 | ||||||||
| Signed by |
