54.226.61.71
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>1100000</MaximumLimit>
  <StartDate>01/25/2015</StartDate>
  <EndDate>02/21/2015</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Murray</Firstname>
    <Middlename>A</Middlename>
    <Lastname>Spence</Lastname>
    <Age>60</Age>
    <Dob>04/07/1954</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>01/25/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>3 Jalan Bisma</Address1>
      <Address2>Box 44</Address2>
      <Country>Indonesia</Country>
      <State></State>
      <City>Ubud</City>
      <Postcode>80571</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>korosolutions@gmail.com</Email>
    <Phone>
      <Home>6282147461327</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Susan Michele Tereba</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Friends</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4520710000154630</CreditcardNumber>
      <NameonCreditcard>Alan Spence</NameonCreditcard>
      <CreditcardExpirationMonth>4</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2015</CreditcardExpirationYear>
      <CreditcardAmount>239.12</CreditcardAmount>
      <CreditcardCodeNumber>957</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
4dbf8d4e
ARS-02-0019479
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0019479</PolicyNumber><UserName>4dbf8d4e</UserName><Password>4dbf8d4e</Password></PolicyDetails></RegistrationRes>