54.86.99.59
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>04/01/2016</StartDate>
  <EndDate>05/16/2016</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Mark</Firstname>
    <Middlename/>
    <Lastname>Henry</Lastname>
    <Age>52</Age>
    <Dob>03/28/1964</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>04/01/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>11 Trotman Walk</Address1>
      <Address2/>
      <Country>United Kingdom</Country>
      <State/>
      <City>Cirencester</City>
      <Postcode>GL71RJ</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>jemmiedolan@mac.com</Email>
    <Phone>
      <Home>3215063929</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>American Express</CreditcardType>
      <CreditcardNumber>374286751661029</CreditcardNumber>
      <NameonCreditcard>Jemmie Dolan</NameonCreditcard>
      <CreditcardExpirationMonth>11</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>186.3</CreditcardAmount>
      <CreditcardCodeNumber>0381</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
cc61a006
ARS-02-0025848
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0025848</PolicyNumber><UserName>cc61a006</UserName><Password>cc61a006</Password></PolicyDetails></RegistrationRes>