52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>0</DeductibleAmount>
  <MaximumLimit>550000</MaximumLimit>
  <StartDate>03/02/2017</StartDate>
  <EndDate>04/01/2017</EndDate>
  <DestinationPlan>Portugal</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Silvia</Firstname>
    <Middlename>M</Middlename>
    <Lastname>Veiga Quadros</Lastname>
    <Age>37</Age>
    <Dob>06/27/1979</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>03/02/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>160 W 71st Street</Address1>
      <Address2>Apt 14P</Address2>
      <Country>United States</Country>
      <State>New York</State>
      <City>New York</City>
      <Postcode>10023</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>silvia_quadros@yahoo.com</Email>
    <Phone>
      <Home>9174469525</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Ronildo Quadros</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Father</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4220612655118147</CreditcardNumber>
      <NameonCreditcard>Ronildo da Silva Quadros</NameonCreditcard>
      <CreditcardExpirationMonth>10</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2023</CreditcardExpirationYear>
      <CreditcardAmount>52.31</CreditcardAmount>
      <CreditcardCodeNumber>657</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
bcaeeb73
ARS-01-0032475
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0032475</PolicyNumber><UserName>bcaeeb73</UserName><Password>bcaeeb73</Password></PolicyDetails></RegistrationRes>