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>05/18/2017</StartDate>
  <EndDate>05/22/2017</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Donald </Firstname>
    <Middlename>H</Middlename>
    <Lastname>Marshall</Lastname>
    <Age>87</Age>
    <Dob>05/16/1930</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>05/18/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>192 Roxton Drive </Address1>
      <Address2/>
      <Country>Canada</Country>
      <State>Ontario</State>
      <City>Waterloo</City>
      <Postcode>N2T 1N8</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>jeanniemarshall@rogers.com</Email>
    <Phone>
      <Home>5198830273</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Jean Marshall</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4516076000865807</CreditcardNumber>
      <NameonCreditcard>Jean Marshall</NameonCreditcard>
      <CreditcardExpirationMonth>2</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>61.25</CreditcardAmount>
      <CreditcardCodeNumber>366</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
4eabe551
ARS-02-0034281
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0034281</PolicyNumber><UserName>4eabe551</UserName><Password>4eabe551</Password></PolicyDetails></RegistrationRes>