54.221.1.109
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>07/13/2014</StartDate>
  <EndDate>08/17/2014</EndDate>
  <DestinationPlan>Chile</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Joyce</Firstname>
    <Middlename/>
    <Lastname>Krohnke</Lastname>
    <Age>16</Age>
    <Dob>10/25/1997</Dob>
    <SportsRider>yes</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>07/13/2014</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>Jose Domingo Albuja 3-72</Address1>
      <Address2>Paraiso de Montecarlo Casa #7</Address2>
      <Country>Ecuador</Country>
      <State></State>
      <City>Ibarra </City>
      <Postcode>EC100104</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>bkrohnke@gmail.com</Email>
    <Phone>
      <Home>593993551949</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName></AdDBeneficiaryName>
    <AdDBeneficiaryRelationship></AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4465421090067677</CreditcardNumber>
      <NameonCreditcard>Brian Krohnke</NameonCreditcard>
      <CreditcardExpirationMonth>5</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2016</CreditcardExpirationYear>
      <CreditcardAmount>57.89</CreditcardAmount>
      <CreditcardCodeNumber>090</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
79d8be1d
ARS-02-0017312
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0017312</PolicyNumber><UserName>79d8be1d</UserName><Password>79d8be1d</Password></PolicyDetails></RegistrationRes>