174.129.122.238
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>110000</MaximumLimit>
  <StartDate>09/08/2016</StartDate>
  <EndDate>09/25/2016</EndDate>
  <DestinationPlan>South Africa</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Elaine</Firstname>
    <Middlename>D</Middlename>
    <Lastname>Florea</Lastname>
    <Age>60</Age>
    <Dob>11/01/1955</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>09/08/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>740 S Federal Hwy</Address1>
      <Address2>Apt 216</Address2>
      <Country>United States</Country>
      <State>Florida</State>
      <City>Pompano Beach</City>
      <Postcode>33062</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>elaine@4rentbythebeach.com</Email>
    <Phone>
      <Home>9544716704</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Adrian Lukis</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Nephew</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5466330096349060</CreditcardNumber>
      <NameonCreditcard>Elaine D Florea</NameonCreditcard>
      <CreditcardExpirationMonth>9</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>64.8</CreditcardAmount>
      <CreditcardCodeNumber>321</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
61128ac5
ARS-01-0029423
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0029423</PolicyNumber><UserName>61128ac5</UserName><Password>61128ac5</Password></PolicyDetails></RegistrationRes>