54.173.37.134
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>12000</MaximumLimit>
  <StartDate>09/08/2016</StartDate>
  <EndDate>09/21/2016</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>pauline</Firstname>
    <Middlename/>
    <Lastname>nichols</Lastname>
    <Age>86</Age>
    <Dob>05/14/1929</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>09/08/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>25 westmorland house, durdham park</Address1>
      <Address2/>
      <Country>United Kingdom</Country>
      <State/>
      <City>bristol</City>
      <Postcode>bs66xh</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>p.m.nichols@btinternet.com</Email>
    <Phone>
      <Home>01179730024</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5186528502719722</CreditcardNumber>
      <NameonCreditcard>pauline  nichols</NameonCreditcard>
      <CreditcardExpirationMonth>9</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2016</CreditcardExpirationYear>
      <CreditcardAmount>199.22</CreditcardAmount>
      <CreditcardCodeNumber>448</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
73d2fbdf
ARS-02-0025471
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0025471</PolicyNumber><UserName>73d2fbdf</UserName><Password>73d2fbdf</Password></PolicyDetails></RegistrationRes>