| Agent | Ulendo Travel Group | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | LL02 | ||||||||
| Effective Date | 03/15/2020 | ||||||||
| Expiry Date | 02/19/2020 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | Johannes Josephus Gerardus Van Oosterhout | ||||||||
| Policy Number | T/UTG334 | ||||||||
| Country of Origin | Malawi | ||||||||
| Destination Area | South Africa | ||||||||
| Address | Partners in Hope | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 43910.89 | ||||||||
| Total Premium (After Tax) | 51,156.18 | ||||||||
| Signed by |
