52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>2000000</MaximumLimit>
  <StartDate>04/05/2018</StartDate>
  <EndDate>04/12/2018</EndDate>
  <DestinationPlan>Brazil</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Thomas</Firstname>
    <Middlename/>
    <Lastname>Guttilla</Lastname>
    <Age>46</Age>
    <Dob>10/01/1971</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>04/05/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>26910 grand Central pkwy</Address1>
      <Address2>apt. 25 B</Address2>
      <Country>United States</Country>
      <State>New York</State>
      <City>Floral Park</City>
      <Postcode>11005</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>andiamo71@yahoo.com</Email>
    <Phone>
      <Home>9142275377</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Thomas Guttilla</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Other</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>American Express</CreditcardType>
      <CreditcardNumber>376768279832008</CreditcardNumber>
      <NameonCreditcard>Luiza Waldrick</NameonCreditcard>
      <CreditcardExpirationMonth>1</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2021</CreditcardExpirationYear>
      <CreditcardAmount>23.84</CreditcardAmount>
      <CreditcardCodeNumber>1278</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
839c6b22
ARS-01-0040203
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0040203</PolicyNumber><UserName>839c6b22</UserName><Password>839c6b22</Password></PolicyDetails></RegistrationRes>