| Agent | Satguru Travel | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | 114 LLW004 | ||||||||
| Effective Date | 05/13/2018 | ||||||||
| Expiry Date | 05/18/2018 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | Maxwell Chifundo Super | ||||||||
| Policy Number | T/STG230 | ||||||||
| Country of Origin | Malawi | ||||||||
| Destination Area | Tanzania | ||||||||
| Address | Satguru Travels | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 47,736.52 | ||||||||
| Total Premium (After Tax) | 47,736.52 | ||||||||
| Signed by |
