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>05/08/2015</StartDate>
  <EndDate>05/20/2015</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Angelina</Firstname>
    <Middlename>D</Middlename>
    <Lastname>Gaceta</Lastname>
    <Age>58</Age>
    <Dob>03/01/1957</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>05/08/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>4  Alice stree</Address1>
      <Address2>rooty hill </Address2>
      <Country>Australia</Country>
      <State></State>
      <City>richmond</City>
      <Postcode>2766</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>boy_angie@yahoo.com</Email>
    <Phone>
      <Home>15107786130</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Mark Jasper Orendain</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Child</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4800138095063451</CreditcardNumber>
      <NameonCreditcard>Gina Gaceta</NameonCreditcard>
      <CreditcardExpirationMonth>5</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2016</CreditcardExpirationYear>
      <CreditcardAmount>52.65</CreditcardAmount>
      <CreditcardCodeNumber>823</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
479c2989
ARS-02-0020999
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0020999</PolicyNumber><UserName>479c2989</UserName><Password>479c2989</Password></PolicyDetails></RegistrationRes>