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>05/31/2015</StartDate>
  <EndDate>06/06/2015</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Miguel</Firstname>
    <Middlename>A</Middlename>
    <Lastname>Mendez</Lastname>
    <Age>36</Age>
    <Dob>09/30/1978</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>05/31/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>km via la Tosacana . Urb. San Miguel  #249</Address1>
      <Address2></Address2>
      <Country>Venezuela</Country>
      <State></State>
      <City>Maturin</City>
      <Postcode>6201</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>miguelmendez11@gmail.com</Email>
    <Phone>
      <Home>584143826585</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Samantha Mendez</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Daughter</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5262271046242052</CreditcardNumber>
      <NameonCreditcard>CARMEN T CAPIA </NameonCreditcard>
      <CreditcardExpirationMonth>9</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2015</CreditcardExpirationYear>
      <CreditcardAmount>13.16</CreditcardAmount>
      <CreditcardCodeNumber>797</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
63ebfab2
ARS-02-0021359
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0021359</PolicyNumber><UserName>63ebfab2</UserName><Password>63ebfab2</Password></PolicyDetails></RegistrationRes>