54.198.247.239
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>08/29/2014</StartDate>
  <EndDate>10/30/2014</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Mark Joseph</Firstname>
    <Middlename>C</Middlename>
    <Lastname>Tirana</Lastname>
    <Age>27</Age>
    <Dob>08/18/1987</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>08/29/2014</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>372 P. Burgos St</Address1>
      <Address2>Gupiing</Address2>
      <Country>Philippines</Country>
      <State></State>
      <City>Binangonan, Rizal</City>
      <Postcode>1940</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>mjtirana.updcs@gmail.com</Email>
    <Phone>
      <Home>011639234546124</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Richard Eaton</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Significant other</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4637783308002389</CreditcardNumber>
      <NameonCreditcard>Richard H Eaton</NameonCreditcard>
      <CreditcardExpirationMonth>1</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2015</CreditcardExpirationYear>
      <CreditcardAmount>86.94</CreditcardAmount>
      <CreditcardCodeNumber>173</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
7a3f3cec
ARS-02-0017811
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0017811</PolicyNumber><UserName>7a3f3cec</UserName><Password>7a3f3cec</Password></PolicyDetails></RegistrationRes>