54.83.122.65
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>1100000</MaximumLimit>
  <StartDate>06/15/2015</StartDate>
  <EndDate>06/26/2015</EndDate>
  <DestinationPlan>Peru</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Kari</Firstname>
    <Middlename>A</Middlename>
    <Lastname>Mahannah</Lastname>
    <Age>40</Age>
    <Dob>01/17/1975</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>06/15/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>1712 west white street </Address1>
      <Address2></Address2>
      <Country>United States</Country>
      <State>Illinois</State>
      <City>Champaign </City>
      <Postcode>61821</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>Kmahannah1@gmail.com</Email>
    <Phone>
      <Home>2179745200</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Amanda Shepherd </AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Mother</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4782002025159890</CreditcardNumber>
      <NameonCreditcard>Kari A Mahannah</NameonCreditcard>
      <CreditcardExpirationMonth>9</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2016</CreditcardExpirationYear>
      <CreditcardAmount>27.0</CreditcardAmount>
      <CreditcardCodeNumber>518</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
527e2c93
ARS-01-0021587
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0021587</PolicyNumber><UserName>527e2c93</UserName><Password>527e2c93</Password></PolicyDetails></RegistrationRes>