52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>12000</MaximumLimit>
  <StartDate>05/01/2017</StartDate>
  <EndDate>12/31/2017</EndDate>
  <DestinationPlan>Ireland</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Josephine</Firstname>
    <Middlename/>
    <Lastname>Martins</Lastname>
    <Age>79</Age>
    <Dob>05/02/1937</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>05/01/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>7411 Quill Dr</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>California</State>
      <City>Downey</City>
      <Postcode>90242</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>Marto402001@yahoo.com</Email>
    <Phone>
      <Home>5628795276</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4100390054558933</CreditcardNumber>
      <NameonCreditcard>Alfred O  Martins</NameonCreditcard>
      <CreditcardExpirationMonth>3</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2021</CreditcardExpirationYear>
      <CreditcardAmount>1408.75</CreditcardAmount>
      <CreditcardCodeNumber>483</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
36640a75
ARS-01-0033756
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0033756</PolicyNumber><UserName>36640a75</UserName><Password>36640a75</Password></PolicyDetails></RegistrationRes>