54.198.116.54
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>12000</MaximumLimit>
  <StartDate>08/08/2014</StartDate>
  <EndDate>08/31/2014</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Janet</Firstname>
    <Middlename/>
    <Lastname>Howorth</Lastname>
    <Age>86</Age>
    <Dob>10/10/1927</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>08/08/2014</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>Room 23 Birch West Hall</Address1>
      <Address2>Parvis Road </Address2>
      <Country>United Kingdom</Country>
      <State></State>
      <City>West Byfleet</City>
      <Postcode>KT146EY</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>charlottehoworth@gmail.com</Email>
    <Phone>
      <Home>011441932338000</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName></AdDBeneficiaryName>
    <AdDBeneficiaryRelationship></AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4124510135503788</CreditcardNumber>
      <NameonCreditcard>Charolette Howorth</NameonCreditcard>
      <CreditcardExpirationMonth>1</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2017</CreditcardExpirationYear>
      <CreditcardAmount>341.52</CreditcardAmount>
      <CreditcardCodeNumber>353</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
7dc5b90c
ARS-02-0017458
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0017458</PolicyNumber><UserName>7dc5b90c</UserName><Password>7dc5b90c</Password></PolicyDetails></RegistrationRes>