| Agent | Libertas Lilongwe |
|---|
| Agent Code | 001 |
|---|
| Effective Date | 06/29/2019 |
|---|
| Expiry Date | 07/10/2019 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | MacBain Happy Joel Mkandawire |
|---|
| Policy Number | T/LL506 |
|---|
| Country of Origin | Malawi |
|---|
| Destination Area | Vienna - Netherlands, and Amstardam - Netherlands |
|---|
| Address | C/O Yoneco
Lilongwe
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| MacBain Happy Joel Mkandawire |
MA898252 |
54 |
43,674.80 |
|
|---|
| Net Premium (Before Tax) | 43,674.80 |
|---|
| Service Fees | 0 |
|---|
| Total Premium (After Tax) | 51,881.04 |
|---|
| Signed by |  |
|---|
