54.86.99.59
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>50000</MaximumLimit>
  <StartDate>04/05/2016</StartDate>
  <EndDate>04/25/2016</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Dora</Firstname>
    <Middlename/>
    <Lastname>Conde</Lastname>
    <Age>75</Age>
    <Dob>04/17/1940</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>04/05/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>Avenida Independencia 2419 13 A</Address1>
      <Address2/>
      <Country>Argentina</Country>
      <State/>
      <City>CABA</City>
      <Postcode>1225</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>meyo917@yahoo.com</Email>
    <Phone>
      <Home>8185355327</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Gabriel Peretti</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Son</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147400145207369</CreditcardNumber>
      <NameonCreditcard>Gabriel Peretti</NameonCreditcard>
      <CreditcardExpirationMonth>12</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2018</CreditcardExpirationYear>
      <CreditcardAmount>170.52</CreditcardAmount>
      <CreditcardCodeNumber>862</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
75f77a7e
ARS-02-0025618
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0025618</PolicyNumber><UserName>75f77a7e</UserName><Password>75f77a7e</Password></PolicyDetails></RegistrationRes>