| Agent | Libertas General Insurance Head Office |
|---|
| Agent Code | BT001 |
|---|
| Effective Date | 03/01/2020 |
|---|
| Expiry Date | 03/07/2020 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | VICTORIA TINA MUNTHALI |
|---|
| Policy Number | T/BT491 |
|---|
| Country of Origin | Malawi |
|---|
| Destination Area | Egypt |
|---|
| Address | P.O Box 512
Blantyre
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| VICTORIA TINA MUNTHALI |
MA562656 |
31 |
43,547.40 |
|
|---|
| Net Premium (Before Tax) | 43,547.40 |
|---|
| Total Premium (After Tax) | 51,732.72 |
|---|
| Signed by |  |
|---|
