54.172.31.188
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>50000</MaximumLimit>
  <StartDate>05/11/2016</StartDate>
  <EndDate>05/18/2016</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Kenneth</Firstname>
    <Middlename>A</Middlename>
    <Lastname>Neal</Lastname>
    <Age>72</Age>
    <Dob>10/18/1943</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>05/11/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>APDO. 0413-00092</Address1>
      <Address2/>
      <Country>Panama</Country>
      <State/>
      <City>Boquete</City>
      <Postcode>0000</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>grupokna@yahoo.ca</Email>
    <Phone>
      <Home>50767806894</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4400661302264079</CreditcardNumber>
      <NameonCreditcard>Kenneth A Neal</NameonCreditcard>
      <CreditcardExpirationMonth>6</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>64.96</CreditcardAmount>
      <CreditcardCodeNumber>086</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
3deb56e0
ARS-02-0026543
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0026543</PolicyNumber><UserName>3deb56e0</UserName><Password>3deb56e0</Password></PolicyDetails></RegistrationRes>