52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>01/25/2018</StartDate>
  <EndDate>01/29/2018</EndDate>
  <DestinationPlan>Canada</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>ARON </Firstname>
    <Middlename>S</Middlename>
    <Lastname>KURTZ</Lastname>
    <Age>18</Age>
    <Dob>01/24/2000</Dob>
    <Gender>Male</Gender>
    <SportsRider>yes</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>01/25/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>1 BLAUVELT RD</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>New York</State>
      <City>MONSEY</City>
      <Postcode>10952-2543</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>kurtzgd@gmail.com</Email>
    <Phone>
      <Home>8453521713</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Rochel Kurtz</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Mother</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>American Express</CreditcardType>
      <CreditcardNumber>371298285821048</CreditcardNumber>
      <NameonCreditcard>ARON  S KURTZ</NameonCreditcard>
      <CreditcardExpirationMonth>5</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2022</CreditcardExpirationYear>
      <CreditcardAmount>8.06</CreditcardAmount>
      <CreditcardCodeNumber>5261</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
977ff28c
ARS-02-0039026
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0039026</PolicyNumber><UserName>977ff28c</UserName><Password>977ff28c</Password></PolicyDetails></RegistrationRes>