54.172.31.188
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>05/16/2016</StartDate>
  <EndDate>05/20/2016</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Eduardo</Firstname>
    <Middlename>A</Middlename>
    <Lastname>Lopes</Lastname>
    <Age>52</Age>
    <Dob>05/03/1964</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>05/16/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>168 Xiró 02517030</Address1>
      <Address2>apto 47</Address2>
      <Country>Brazil</Country>
      <State/>
      <City>São Paulo</City>
      <Postcode>02517030</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>edalobr@yahoo.com.br</Email>
    <Phone>
      <Home>5511957710699</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Sonia Garcia Fonte Lopes</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4901720231724118</CreditcardNumber>
      <NameonCreditcard>Eduardo A Lopes</NameonCreditcard>
      <CreditcardExpirationMonth>7</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2017</CreditcardExpirationYear>
      <CreditcardAmount>20.25</CreditcardAmount>
      <CreditcardCodeNumber>903</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
3c0ffd93
ARS-02-0026719
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0026719</PolicyNumber><UserName>3c0ffd93</UserName><Password>3c0ffd93</Password></PolicyDetails></RegistrationRes>