54.226.34.195
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>50000</MaximumLimit>
  <StartDate>01/10/2015</StartDate>
  <EndDate>01/30/2015</EndDate>
  <DestinationPlan>Mexico</DestinationPlan>
  <NoOfApplicants>2</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Gerald</Firstname>
    <Middlename>R</Middlename>
    <Lastname>Chrapko</Lastname>
    <Age>74</Age>
    <Dob>06/25/1940</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
  <Applicant>
    <Firstname>Mary</Firstname>
    <Middlename>J</Middlename>
    <Lastname>Chrapko</Lastname>
    <Age>73</Age>
    <Dob>11/03/1941</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>01/10/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>`1250 Limeridge Rd East Unit 13 </Address1>
      <Address2></Address2>
      <Country>Canada</Country>
      <State>Ontario</State>
      <City>Hamilton</City>
      <Postcode>L8W1P1</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>jerry.bones@gmail.com</Email>
    <Phone>
      <Home>9055747395</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>:Lindsay Chrapko</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Daughter</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>American Express</CreditcardType>
      <CreditcardNumber>373350800271015</CreditcardNumber>
      <NameonCreditcard>Gerald  Chrapko</NameonCreditcard>
      <CreditcardExpirationMonth>11</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2018</CreditcardExpirationYear>
      <CreditcardAmount>270.9</CreditcardAmount>
      <CreditcardCodeNumber>1811</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
090b7583
3d6417ef
ARS-01-0019272
ARS-01-0019273
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0019272</PolicyNumber><UserName>090b7583</UserName><Password>090b7583</Password></PolicyDetails><PolicyDetails><PolicyNumber>ARS-01-0019273</PolicyNumber><UserName>3d6417ef</UserName><Password>3d6417ef</Password></PolicyDetails></RegistrationRes>