| Agent | Rennies Travel |
|---|
| Agent Code | LL016 |
|---|
| Effective Date | 10/28/2017 |
|---|
| Expiry Date | 11/05/2017 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | FOSTER ALFRED CHANCE KHOLOWA |
|---|
| Policy Number | T/RT352 |
|---|
| Country of Origin | MALAWI |
|---|
| Destination Area | GUINEA BISSAU |
|---|
| Address | RENNIES TRAVEL
P.O.BOX 31335
LILONGWE
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| FOSTER ALFRED CHANCE KHOLOWA |
MA017440 |
46 |
38,363.00 |
|
|---|
| Net Premium (Before Tax) | 38,363.00 |
|---|
| Service Fees | 10000 |
|---|
| Total Premium (After Tax) | 44,692.90 |
|---|
| Signed by |  |
|---|
