| Agent | Ulendo Travel Group |
|---|
| Agent Code | LL002 |
|---|
| Effective Date | 03/23/2020 |
|---|
| Expiry Date | 10/03/2020 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | DE SOUZA/MARJORIE MRS |
|---|
| Policy Number | T/UTG335 |
|---|
| Country of Origin | MALAWI |
|---|
| Destination Area | UNITED KINGDOM, PORTUGAL AND ITALY |
|---|
| Address | C/O Claudette MacAdam
P.O. Box 30728
Lilongwe 3
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| DE SOUZA/MARJORIE MRS |
MA060975 |
67 |
Full Package |
|
|---|
| Net Premium (Before Tax) | 394440 |
|---|
| Total Premium (After Tax) | 459522 |
|---|
| Signed by |  |
|---|
