54.83.122.65
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>1100000</MaximumLimit>
  <StartDate>08/08/2015</StartDate>
  <EndDate>08/19/2015</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>2</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Daniel</Firstname>
    <Middlename/>
    <Lastname>Fogle</Lastname>
    <Age>30</Age>
    <Dob>05/08/1985</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
  <Applicant>
    <Firstname>Au</Firstname>
    <Middlename/>
    <Lastname>Kiyosawa</Lastname>
    <Age>31</Age>
    <Dob>10/09/1983</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>08/08/2015</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>2-16-21 Yanagibashi 804, Taito-ku </Address1>
      <Address2></Address2>
      <Country>Japan</Country>
      <State></State>
      <City>Tokyo</City>
      <Postcode>111-0052</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>marsha.fogle@gmail.com</Email>
    <Phone>
      <Home>08013789910</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName></AdDBeneficiaryName>
    <AdDBeneficiaryRelationship></AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147202191597754</CreditcardNumber>
      <NameonCreditcard>Marsha J Fogle</NameonCreditcard>
      <CreditcardExpirationMonth>11</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2017</CreditcardExpirationYear>
      <CreditcardAmount>77.28</CreditcardAmount>
      <CreditcardCodeNumber>389</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
f79242b5
89ed183a
ARS-02-0022294
ARS-02-0022295
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0022294</PolicyNumber><UserName>f79242b5</UserName><Password>f79242b5</Password></PolicyDetails><PolicyDetails><PolicyNumber>ARS-02-0022295</PolicyNumber><UserName>89ed183a</UserName><Password>89ed183a</Password></PolicyDetails></RegistrationRes>