54.242.172.204
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>110000</MaximumLimit>
  <StartDate>04/02/2015</StartDate>
  <EndDate>04/14/2015</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Sumiko</Firstname>
    <Middlename/>
    <Lastname>Umei</Lastname>
    <Age>66</Age>
    <Dob>08/07/1948</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>04/02/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>67 Lady Davidson Circuit</Address1>
      <Address2></Address2>
      <Country>Australia</Country>
      <State></State>
      <City>Forestville</City>
      <Postcode>2087</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>ken.umei@hal.hitachi.com</Email>
    <Phone>
      <Home>19148308957</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Kentaro Umei</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Son</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4266841339120972</CreditcardNumber>
      <NameonCreditcard>Kentaro Umei</NameonCreditcard>
      <CreditcardExpirationMonth>11</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2016</CreditcardExpirationYear>
      <CreditcardAmount>98.28</CreditcardAmount>
      <CreditcardCodeNumber>742</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
6318bda5
ARS-02-0020352
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0020352</PolicyNumber><UserName>6318bda5</UserName><Password>6318bda5</Password></PolicyDetails></RegistrationRes>