54.226.61.71
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>550000</MaximumLimit>
  <StartDate>01/08/2015</StartDate>
  <EndDate>01/18/2015</EndDate>
  <DestinationPlan>Puerto Rico</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Tonya</Firstname>
    <Middlename/>
    <Lastname>Peterson</Lastname>
    <Age>39</Age>
    <Dob>01/24/1975</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>01/08/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>16073 Via Paro</Address1>
      <Address2></Address2>
      <Country>United States</Country>
      <State>California</State>
      <City>San Lorenzo</City>
      <Postcode>94580</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>tpeterson6@yahoo.com</Email>
    <Phone>
      <Home>2096039805</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Alan Peterson</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Father</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147098447642836</CreditcardNumber>
      <NameonCreditcard>Tonya  Peterson</NameonCreditcard>
      <CreditcardExpirationMonth>4</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2016</CreditcardExpirationYear>
      <CreditcardAmount>16.94</CreditcardAmount>
      <CreditcardCodeNumber>500</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
d21d0efc
ARS-01-0019291
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0019291</PolicyNumber><UserName>d21d0efc</UserName><Password>d21d0efc</Password></PolicyDetails></RegistrationRes>