52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>50000</MaximumLimit>
  <StartDate>03/04/2018</StartDate>
  <EndDate>03/30/2018</EndDate>
  <DestinationPlan>Chile</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Raul</Firstname>
    <Middlename/>
    <Lastname>Moldes Lopez</Lastname>
    <Age>76</Age>
    <Dob>11/22/1941</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>03/04/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>10265 NW 57th terrace </Address1>
      <Address2/>
      <Country>United States</Country>
      <State>Florida</State>
      <City>Doral</City>
      <Postcode>33178</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>lupitamoldes2011@gmail.com</Email>
    <Phone>
      <Home>7868530733</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Luz Moldes Rojas</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5466160320421249</CreditcardNumber>
      <NameonCreditcard>Raul  Moldes Lopez</NameonCreditcard>
      <CreditcardExpirationMonth>4</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2018</CreditcardExpirationYear>
      <CreditcardAmount>155.25</CreditcardAmount>
      <CreditcardCodeNumber>679</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
334ad6cf
ARS-01-0039640
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0039640</PolicyNumber><UserName>334ad6cf</UserName><Password>334ad6cf</Password></PolicyDetails></RegistrationRes>