52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>05/10/2017</StartDate>
  <EndDate>05/15/2017</EndDate>
  <DestinationPlan>Netherlands</DestinationPlan>
  <NoOfApplicants>2</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Brent</Firstname>
    <Middlename>W</Middlename>
    <Lastname>Gladney</Lastname>
    <Age>29</Age>
    <Dob>06/29/1987</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
  <Applicant>
    <Firstname>Lindsay</Firstname>
    <Middlename>J</Middlename>
    <Lastname>Sutton</Lastname>
    <Age>35</Age>
    <Dob>08/22/1981</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>05/10/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>916 Delaware Ave</Address1>
      <Address2>3N</Address2>
      <Country>United States</Country>
      <State>New York</State>
      <City>Buffalo</City>
      <Postcode>14209</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>brentgladney@live.com</Email>
    <Phone>
      <Home>7168642050</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Lindsay Sutton</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147202255871376</CreditcardNumber>
      <NameonCreditcard>Brent Gladney</NameonCreditcard>
      <CreditcardExpirationMonth>4</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>9.96</CreditcardAmount>
      <CreditcardCodeNumber>439</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
948bf23b
b5148b09
ARS-01-0034057
ARS-01-0034058
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0034057</PolicyNumber><UserName>948bf23b</UserName><Password>948bf23b</Password></PolicyDetails><PolicyDetails><PolicyNumber>ARS-01-0034058</PolicyNumber><UserName>b5148b09</UserName><Password>b5148b09</Password></PolicyDetails></RegistrationRes>