| Agent | Rennies Travel |
|---|
| Agent Code | LL016 |
|---|
| Effective Date | 04/01/2019 |
|---|
| Expiry Date | 04/07/2019 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | HARRIET MEMORY DIDA CHIOMBA |
|---|
| Policy Number | T/RT156 |
|---|
| Country of Origin | MALAWI |
|---|
| Destination Area | RWANDA |
|---|
| Address | MANICA TRAVEL
P.O.BOX 31335
LILONGWE
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| HARRIET MEMORY DIDA CHIOMBA |
MA043604 |
51 |
43,674.80 |
|
|---|
| Net Premium (Before Tax) | 50,881.14 |
|---|
| Total Premium (After Tax) | 60,811.00 |
|---|
| Signed by |  |
|---|
