54.198.116.54
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>09/04/2014</StartDate>
  <EndDate>09/15/2014</EndDate>
  <DestinationPlan>United Kingdom</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Miriam</Firstname>
    <Middlename>L</Middlename>
    <Lastname>Wilsen</Lastname>
    <Age>54</Age>
    <Dob>11/10/1959</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>09/04/2014</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>9018 15th Ave. N.W.</Address1>
      <Address2></Address2>
      <Country>United States</Country>
      <State>Washington</State>
      <City>Seattle</City>
      <Postcode>98117</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>delmelza@yahoo.com</Email>
    <Phone>
      <Home>2067826764</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Harold Caron</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Father</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4428680500739276</CreditcardNumber>
      <NameonCreditcard>Miriam Wilsen</NameonCreditcard>
      <CreditcardExpirationMonth>8</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2015</CreditcardExpirationYear>
      <CreditcardAmount>36.72</CreditcardAmount>
      <CreditcardCodeNumber>384</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
d49a9920
ARS-01-0017870
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0017870</PolicyNumber><UserName>d49a9920</UserName><Password>d49a9920</Password></PolicyDetails></RegistrationRes>