Agent | Libertas Lilongwe | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | 001 | ||||||||
Effective Date | 11/29/2019 | ||||||||
Expiry Date | 12/14/2019 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Full Package A-I | ||||||||
Name of Policy Holder | Hendricks Shyalulole Mgodie | ||||||||
Policy Number | T/LL563 | ||||||||
Country of Origin | Malawi | ||||||||
Destination Area | Spain | ||||||||
Address | P. O. Box 30377, Lilongwe | ||||||||
Number of Passengers | 1 | ||||||||
List of persons insured |
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Net Premium (Before Tax) | 48,212.75 | ||||||||
Total Premium (After Tax) | 57,167.85 | ||||||||
Signed by |