54.198.247.239
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>550000</MaximumLimit>
  <StartDate>08/31/2014</StartDate>
  <EndDate>09/08/2014</EndDate>
  <DestinationPlan>Netherlands</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Ronald</Firstname>
    <Middlename>L</Middlename>
    <Lastname>Bultje</Lastname>
    <Age>32</Age>
    <Dob>12/07/1981</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>08/31/2014</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>21 West Street</Address1>
      <Address2>31B</Address2>
      <Country>United States</Country>
      <State>New York</State>
      <City>New York</City>
      <Postcode>10006</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>rsbultje@gmail.com</Email>
    <Phone>
      <Home>6465302015</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Li Ling Lee</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5262193059727136</CreditcardNumber>
      <NameonCreditcard>Li Ling Lee</NameonCreditcard>
      <CreditcardExpirationMonth>6</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2017</CreditcardExpirationYear>
      <CreditcardAmount>13.86</CreditcardAmount>
      <CreditcardCodeNumber>110</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
5256f831
ARS-01-0017953
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0017953</PolicyNumber><UserName>5256f831</UserName><Password>5256f831</Password></PolicyDetails></RegistrationRes>