52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>550000</MaximumLimit>
  <StartDate>07/16/2019</StartDate>
  <EndDate>08/03/2019</EndDate>
  <DestinationPlan>Italy</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Randi</Firstname>
    <Middlename>L</Middlename>
    <Lastname>Gulseth</Lastname>
    <Age>63</Age>
    <Dob>07/04/1956</Dob>
    <Gender>Female</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>07/16/2019</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>92098 Alderwood Rd</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>Oregon</State>
      <City>Coos Bay</City>
      <Postcode>97420</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>idnar56@gmail.com</Email>
    <Phone>
      <Home>5412972138</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Randi L Gulseth</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Other</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4388576115834361</CreditcardNumber>
      <NameonCreditcard>Randi L Gulseth RN</NameonCreditcard>
      <CreditcardExpirationMonth>4</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2021</CreditcardExpirationYear>
      <CreditcardAmount>88.35</CreditcardAmount>
      <CreditcardCodeNumber>353</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
fd84a8e4
701938406

<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>701938406</PolicyNumber><UserName>fd84a8e4</UserName><Password>fd84a8e4</Password></PolicyDetails></RegistrationRes>