| Agent | Libertas Lilongwe | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | 001 | ||||||||
| Effective Date | 01/10/2019 | ||||||||
| Expiry Date | 01/31/2019 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | Olive Eleanor Jumbe | ||||||||
| Policy Number | T/LL469 | ||||||||
| Country of Origin | Malawi | ||||||||
| Destination Area | Ireland | ||||||||
| Address | P/Bag 134 | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 65,186.60 | ||||||||
| Service Fees | 0 | ||||||||
| Total Premium (After Tax) | 75,942.39 | ||||||||
| Signed by |
