54.226.61.71
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>01/16/2015</StartDate>
  <EndDate>02/01/2015</EndDate>
  <DestinationPlan>Iceland</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Serge</Firstname>
    <Middlename/>
    <Lastname>Kruppa</Lastname>
    <Age>43</Age>
    <Dob>07/25/1971</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>01/16/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>Calle 6B Sur #37-45, Apto 1807, Urb. Santafe</Address1>
      <Address2></Address2>
      <Country>Colombia</Country>
      <State></State>
      <City>Medellin</City>
      <Postcode>NA</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>serge@elasticall.com</Email>
    <Phone>
      <Home>14088444114</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Luisa Alzate</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Significant other</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4056530060723021</CreditcardNumber>
      <NameonCreditcard>Serge  Kruppa</NameonCreditcard>
      <CreditcardExpirationMonth>10</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2015</CreditcardExpirationYear>
      <CreditcardAmount>47.6</CreditcardAmount>
      <CreditcardCodeNumber>171</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
02e393a8
ARS-02-0019337
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0019337</PolicyNumber><UserName>02e393a8</UserName><Password>02e393a8</Password></PolicyDetails></RegistrationRes>