54.234.109.243
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>04/03/2015</StartDate>
  <EndDate>04/30/2015</EndDate>
  <DestinationPlan>Great Britain (UK)</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Danielle</Firstname>
    <Middlename>L</Middlename>
    <Lastname>Nakashima</Lastname>
    <Age>23</Age>
    <Dob>06/12/1991</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>04/03/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>11625 Baird Ave</Address1>
      <Address2></Address2>
      <Country>United States</Country>
      <State>California</State>
      <City>Porter Ranch</City>
      <Postcode>91326</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>junji49@yahoo.com</Email>
    <Phone>
      <Home>8186214606</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Susan Nakashima</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Mother</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4342562087901334</CreditcardNumber>
      <NameonCreditcard>Junji H Nakashima</NameonCreditcard>
      <CreditcardExpirationMonth>9</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2016</CreditcardExpirationYear>
      <CreditcardAmount>23.8</CreditcardAmount>
      <CreditcardCodeNumber>747</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
fa5514f6
ARS-01-0020445
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0020445</PolicyNumber><UserName>fa5514f6</UserName><Password>fa5514f6</Password></PolicyDetails></RegistrationRes>