54.83.122.65
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>07/08/2015</StartDate>
  <EndDate>07/28/2015</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Judith</Firstname>
    <Middlename>A</Middlename>
    <Lastname>Mitchell</Lastname>
    <Age>49</Age>
    <Dob>04/01/1966</Dob>
    <SportsRider>yes</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>07/08/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>13456 Via Varra Road #239</Address1>
      <Address2></Address2>
      <Country>Thailand</Country>
      <State></State>
      <City>Broomfield</City>
      <Postcode>80020</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>judyinthailand@gmail.com</Email>
    <Phone>
      <Home>66896717614</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Tim Mitchell</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4388576073119433</CreditcardNumber>
      <NameonCreditcard>Judith A Mitchell</NameonCreditcard>
      <CreditcardExpirationMonth>8</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2016</CreditcardExpirationYear>
      <CreditcardAmount>70.56</CreditcardAmount>
      <CreditcardCodeNumber>875</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
0d1f303a
ARS-02-0022007
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0022007</PolicyNumber><UserName>0d1f303a</UserName><Password>0d1f303a</Password></PolicyDetails></RegistrationRes>