52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>12000</MaximumLimit>
  <StartDate>05/24/2017</StartDate>
  <EndDate>06/18/2017</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Tam</Firstname>
    <Middlename>M</Middlename>
    <Lastname>Nguyen</Lastname>
    <Age>93</Age>
    <Dob>10/25/1923</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>05/24/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>168 John Street Apt # 503</Address1>
      <Address2/>
      <Country>Canada</Country>
      <State>Ontario</State>
      <City>Toronto</City>
      <Postcode>m5t2x9</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>lynnvy@yahoo.com</Email>
    <Phone>
      <Home>4169776266</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Lan nguyen</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Daughter</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147202274893872</CreditcardNumber>
      <NameonCreditcard>Tam M Nguyen</NameonCreditcard>
      <CreditcardExpirationMonth>9</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>318.5</CreditcardAmount>
      <CreditcardCodeNumber>399</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
7b5056cc
ARS-02-0034188
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0034188</PolicyNumber><UserName>7b5056cc</UserName><Password>7b5056cc</Password></PolicyDetails></RegistrationRes>