52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>08/31/2018</StartDate>
  <EndDate>09/23/2018</EndDate>
  <DestinationPlan>Brazil</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Samuel</Firstname>
    <Middlename/>
    <Lastname>Spares da Silva </Lastname>
    <Age>28</Age>
    <Dob>04/30/1990</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>08/31/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>17007 Matinal Road</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>California</State>
      <City>San Diego</City>
      <Postcode>92127</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>samusoares90@gmail.com</Email>
    <Phone>
      <Home>8589146026</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>David Walton </AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>American Express</CreditcardType>
      <CreditcardNumber>373957578997009</CreditcardNumber>
      <NameonCreditcard>Samuel  Spares da Silva </NameonCreditcard>
      <CreditcardExpirationMonth>5</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2023</CreditcardExpirationYear>
      <CreditcardAmount>18.24</CreditcardAmount>
      <CreditcardCodeNumber>4462</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
ce0dde22
701800339

<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>701800339</PolicyNumber><UserName>ce0dde22</UserName><Password>ce0dde22</Password></PolicyDetails></RegistrationRes>