54.242.172.204
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>05/06/2015</StartDate>
  <EndDate>05/24/2015</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Daniel</Firstname>
    <Middlename/>
    <Lastname>Uchoa</Lastname>
    <Age>34</Age>
    <Dob>12/15/1980</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>05/06/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>R. Francisco Carlos Pereira Netto, 100</Address1>
      <Address2></Address2>
      <Country>Brazil</Country>
      <State></State>
      <City>JUNDIAÍ</City>
      <Postcode>13215-465</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>danieluchoa@gmail.com</Email>
    <Phone>
      <Home>5511985740800</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName></AdDBeneficiaryName>
    <AdDBeneficiaryRelationship></AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5350810238540741</CreditcardNumber>
      <NameonCreditcard>Severina A da C Uchoa</NameonCreditcard>
      <CreditcardExpirationMonth>11</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2022</CreditcardExpirationYear>
      <CreditcardAmount>35.72</CreditcardAmount>
      <CreditcardCodeNumber>783</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
535a7359
ARS-02-0020961
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0020961</PolicyNumber><UserName>535a7359</UserName><Password>535a7359</Password></PolicyDetails></RegistrationRes>