52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>03/21/2018</StartDate>
  <EndDate>03/25/2018</EndDate>
  <DestinationPlan>Costa Rica</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Peter</Firstname>
    <Middlename/>
    <Lastname>Nieuwenhuizen</Lastname>
    <Age>49</Age>
    <Dob>08/09/1968</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>03/21/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>689 Minnesota ave</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>Florida</State>
      <City>Winter Park </City>
      <Postcode>32789</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>speedloop@aol.com</Email>
    <Phone>
      <Home>4074928361</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Liliosa Bento</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Fiance</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4266841424297578</CreditcardNumber>
      <NameonCreditcard>Peter  Nieuwenhuizen</NameonCreditcard>
      <CreditcardExpirationMonth>6</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2018</CreditcardExpirationYear>
      <CreditcardAmount>7.5</CreditcardAmount>
      <CreditcardCodeNumber>361</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
25164bf6
ARS-01-0039952
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0039952</PolicyNumber><UserName>25164bf6</UserName><Password>25164bf6</Password></PolicyDetails></RegistrationRes>