| Agent | Libertas Lilongwe |
|---|
| Agent Code | LL001 |
|---|
| Effective Date | 01/06/2018 |
|---|
| Expiry Date | 01/25/2018 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | Youngs Alfred Zebedia Yangazu Nyirenda |
|---|
| Policy Number | T/LLGIS 348 |
|---|
| Country of Origin | Malawi |
|---|
| Destination Area | India |
|---|
| Address | Lilongwe
Malawi
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| Youngs Alfred Zebedia Yangazu Nyirenda |
MA015533 |
43 |
53,631.24 |
|
|---|
| Net Premium (Before Tax) | 53,631.24 |
|---|
| Service Fees | 0 |
|---|
| Total Premium (After Tax) | 53,631.24 |
|---|
| Signed by |  |
|---|
