54.80.29.182
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>05/06/2014</StartDate>
  <EndDate>06/25/2014</EndDate>
  <DestinationPlan>Canada</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Juan Jose </Firstname>
    <Middlename/>
    <Lastname>Ramos</Lastname>
    <Age>36</Age>
    <Dob>01/25/1978</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>05/06/2014</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>145 Pine Haven Shores rd</Address1>
      <Address2></Address2>
      <Country>United States</Country>
      <State>California</State>
      <City>Shelburne</City>
      <Postcode>05482</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>LYELLE@CAVALIA.NET</Email>
    <Phone>
      <Home>5147773340</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Cavalia USA inc</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Not recorded</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4807073008822888</CreditcardNumber>
      <NameonCreditcard>Daphne Mollenthiel</NameonCreditcard>
      <CreditcardExpirationMonth>3</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2015</CreditcardExpirationYear>
      <CreditcardAmount>95.88</CreditcardAmount>
      <CreditcardCodeNumber>879</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
8b50dd50
ARS-02-0016361
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0016361</PolicyNumber><UserName>8b50dd50</UserName><Password>8b50dd50</Password></PolicyDetails></RegistrationRes>