RE: Travel Insurance Policy Amendment

December 19, 2011

RANDY ORTAN

6901 West Main 26 Street

Urbana • Illinois, 61801

Cell: 257-409-8975

[Subject: Normally bold, summarizes the intention of the letter] -Optional-

Dear RANDY ORTAN,

” FACSIMILE MEMORANDUM

=================================================================

DATE: October 30, 2010, 11:20 a.m.

TO: Ram Daniels, Visa Applicant

4567 Genesis Highway

Westchester, IL 2344

Telephone: 321-0000

Fax: 321-0001

FROM: Jenna Matthews, Travel Sales Manager

Rainbow Insurance

704 Cardinal Avenue

Chicago, IL 50501

Telephone: 344-44555

Fax: 344-4456

PAGES: 5 (Including Cover Sheet)

RE: Travel Insurance Policy Amendment

================================================================= ”

Sincerely,

Hedva

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