Agent | Libertas Lilongwe | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | LL001 | ||||||||
Effective Date | 11/19/2017 | ||||||||
Expiry Date | 11/26/2017 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Full Package A-I | ||||||||
Name of Policy Holder | OMAR JABIR MAGOMBO | ||||||||
Policy Number | T/LL 336 | ||||||||
Country of Origin | MALAWI | ||||||||
Destination Area | MALTA | ||||||||
Address | P/BAG 138 | ||||||||
Number of Passengers | 1 | ||||||||
List of persons insured |
| ||||||||
Net Premium (Before Tax) | 48,131.04 | ||||||||
Service Fees | 0 | ||||||||
Total Premium (After Tax) | 48,131.04 | ||||||||
Signed by |