| Agent | Libertas General Insurance Lilongwe Branch |
|---|
| Agent Code | LL001 |
|---|
| Effective Date | 11/18/2017 |
|---|
| Expiry Date | 11/26/2017 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | Rosemary Emma Nawasha |
|---|
| Policy Number | T/LL339 |
|---|
| Country of Origin | Malawi |
|---|
| Destination Area | Malta |
|---|
| Address | P.O Box 1
Mchinji.
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| Rosemary Emma Nawasha |
MS003135 |
48 |
43,674.80 |
|
|---|
| Net Premium (Before Tax) | 43,674.80 |
|---|
| Total Premium (After Tax) | 51,881.14 |
|---|
| Signed by |  |
|---|
