54.204.126.246
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>50000</MaximumLimit>
  <StartDate>04/30/2014</StartDate>
  <EndDate>06/12/2014</EndDate>
  <DestinationPlan>Spain</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Gerald</Firstname>
    <Middlename>E</Middlename>
    <Lastname>Leighton</Lastname>
    <Age>70</Age>
    <Dob>09/17/1943</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>04/30/2014</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>21889 S 193rd St</Address1>
      <Address2></Address2>
      <Country>United States</Country>
      <State>Arizona</State>
      <City>Queen Creek</City>
      <Postcode>85142</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>jerry.leighton@gmail.com</Email>
    <Phone>
      <Home>4808821178</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Betty Leighton</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5291499701312473</CreditcardNumber>
      <NameonCreditcard>Gerald E Leighton</NameonCreditcard>
      <CreditcardExpirationMonth>11</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2014</CreditcardExpirationYear>
      <CreditcardAmount>283.8</CreditcardAmount>
      <CreditcardCodeNumber>625</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
c47ecb34
ARS-01-0015846
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0015846</PolicyNumber><UserName>c47ecb34</UserName><Password>c47ecb34</Password></PolicyDetails></RegistrationRes>