52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>06/11/2017</StartDate>
  <EndDate>07/31/2017</EndDate>
  <DestinationPlan>France</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>vesna</Firstname>
    <Middlename/>
    <Lastname>Leamer</Lastname>
    <Age>67</Age>
    <Dob>03/27/1950</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>06/11/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>400 South Ocean Blvd. </Address1>
      <Address2>apt 422</Address2>
      <Country>United States</Country>
      <State>Florida</State>
      <City>Palm Beach</City>
      <Postcode>33480</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>vesna.leamer@gmail.com</Email>
    <Phone>
      <Home>2022558463</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Laurence Leamer</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Not recorded</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>American Express</CreditcardType>
      <CreditcardNumber>376768298351006</CreditcardNumber>
      <NameonCreditcard>Laurence Leamer</NameonCreditcard>
      <CreditcardExpirationMonth>10</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2021</CreditcardExpirationYear>
      <CreditcardAmount>197.88</CreditcardAmount>
      <CreditcardCodeNumber>0035</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
68980408
ARS-01-0034785
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0034785</PolicyNumber><UserName>68980408</UserName><Password>68980408</Password></PolicyDetails></RegistrationRes>