52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>06/21/2019</StartDate>
  <EndDate>06/28/2019</EndDate>
  <DestinationPlan>Georgia</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Jeremy</Firstname>
    <Middlename/>
    <Lastname>Toettcher</Lastname>
    <Age>39</Age>
    <Dob>02/11/1980</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>06/21/2019</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>276 5th Ave </Address1>
      <Address2/>
      <Country>Ireland</Country>
      <State/>
      <City>San Francisco </City>
      <Postcode>94118</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>Jtoettcher@intrepid-spirits.com</Email>
    <Phone>
      <Home>14154817320</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Jeremy Toettcher</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Sister</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147202361410234</CreditcardNumber>
      <NameonCreditcard>Jeremy Toettcher </NameonCreditcard>
      <CreditcardExpirationMonth>7</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2023</CreditcardExpirationYear>
      <CreditcardAmount>13.12</CreditcardAmount>
      <CreditcardCodeNumber>732</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
db855a75
701937311

<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>701937311</PolicyNumber><UserName>db855a75</UserName><Password>db855a75</Password></PolicyDetails></RegistrationRes>