54.87.230.228
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>110000</MaximumLimit>
  <StartDate>08/12/2016</StartDate>
  <EndDate>08/11/2017</EndDate>
  <DestinationPlan>Costa Rica</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Mallory</Firstname>
    <Middlename>N</Middlename>
    <Lastname>Robert</Lastname>
    <Age>22</Age>
    <Dob>09/27/1993</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>08/12/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>1414 LAUREL LN</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>Texas</State>
      <City>SOUTHLAKE</City>
      <Postcode>76092</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>robert.doc77@gmail.com</Email>
    <Phone>
      <Home>8179662765</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>W PIERRE ROBERT</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Father</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4400667080979697</CreditcardNumber>
      <NameonCreditcard>William Pierre Robert</NameonCreditcard>
      <CreditcardExpirationMonth>3</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>346.75</CreditcardAmount>
      <CreditcardCodeNumber>010</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
eff74bc3
ARS-01-0028775
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0028775</PolicyNumber><UserName>eff74bc3</UserName><Password>eff74bc3</Password></PolicyDetails></RegistrationRes>