| Agent | Ulendo Travel Group | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | LL002 | ||||||||
| Effective Date | 11/07/2019 | ||||||||
| Expiry Date | 11/08/2019 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | GUPTA/SUNDEEP KUMAR MR | ||||||||
| Policy Number | T/UTG323 | ||||||||
| Country of Origin | MALAWI | ||||||||
| Destination Area | SOUTH AFRICA | ||||||||
| Address | C/O Partners in Hope | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 43734 | ||||||||
| Total Premium (After Tax) | 50950 | ||||||||
| Signed by |
