54.86.99.59
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>0</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>04/21/2016</StartDate>
  <EndDate>06/23/2016</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Anca</Firstname>
    <Middlename>A</Middlename>
    <Lastname>Berta</Lastname>
    <Age>33</Age>
    <Dob>04/22/1982</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>04/21/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>Episcop Roman Ciorogariu 165</Address1>
      <Address2/>
      <Country>Romania</Country>
      <State/>
      <City>Arad</City>
      <Postcode>310058</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>langemanifesto@yahoo.com</Email>
    <Phone>
      <Home>40757333895</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4120397334129662</CreditcardNumber>
      <NameonCreditcard>Joohong N Lange</NameonCreditcard>
      <CreditcardExpirationMonth>2</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>150.4</CreditcardAmount>
      <CreditcardCodeNumber>847</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
f7568b6b
ARS-02-0026276
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0026276</PolicyNumber><UserName>f7568b6b</UserName><Password>f7568b6b</Password></PolicyDetails></RegistrationRes>