54.89.137.34
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>05/23/2015</StartDate>
  <EndDate>07/23/2015</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Cuc</Firstname>
    <Middlename>T</Middlename>
    <Lastname>Thai</Lastname>
    <Age>58</Age>
    <Dob>05/02/1957</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>05/23/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>C13/25 Ap 5 Xa Binh Hung</Address1>
      <Address2>Huyen Binh Chanh</Address2>
      <Country>Viet Nam</Country>
      <State></State>
      <City>Ho Chi Minh</City>
      <Postcode>none</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>xcle@comcast.net</Email>
    <Phone>
      <Home>84937238354</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>KimPhuc T. Do</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Daughter</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147202023813288</CreditcardNumber>
      <NameonCreditcard>Xuan C Le</NameonCreditcard>
      <CreditcardExpirationMonth>8</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2015</CreditcardExpirationYear>
      <CreditcardAmount>251.1</CreditcardAmount>
      <CreditcardCodeNumber>452</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
bc22ff45
ARS-02-0021276
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0021276</PolicyNumber><UserName>bc22ff45</UserName><Password>bc22ff45</Password></PolicyDetails></RegistrationRes>