174.129.122.238
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>110000</MaximumLimit>
  <StartDate>08/24/2016</StartDate>
  <EndDate>08/30/2016</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Jacquelyn</Firstname>
    <Middlename>R</Middlename>
    <Lastname>Brookes</Lastname>
    <Age>56</Age>
    <Dob>05/10/1960</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>08/24/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>68 Smithe Street</Address1>
      <Address2>Suite 612</Address2>
      <Country>Canada</Country>
      <State>British Columbia</State>
      <City>Vancouver</City>
      <Postcode>V6B0P4</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>jacqui@abetterchanceservices.com</Email>
    <Phone>
      <Home>7789862229</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4512238766471063</CreditcardNumber>
      <NameonCreditcard>Jacquelyn Brookes</NameonCreditcard>
      <CreditcardExpirationMonth>2</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2018</CreditcardExpirationYear>
      <CreditcardAmount>32.06</CreditcardAmount>
      <CreditcardCodeNumber>672</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
e3a3666f
ARS-02-0029056
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0029056</PolicyNumber><UserName>e3a3666f</UserName><Password>e3a3666f</Password></PolicyDetails></RegistrationRes>