174.129.122.238
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>0</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>09/26/2016</StartDate>
  <EndDate>10/10/2016</EndDate>
  <DestinationPlan>Belgium</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Sebastian</Firstname>
    <Middlename/>
    <Lastname>Rojas Gonzalez</Lastname>
    <Age>27</Age>
    <Dob>10/22/1988</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>09/26/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>Barrio La Trinidad, Ciudad Colon</Address1>
      <Address2/>
      <Country>Costa Rica</Country>
      <State/>
      <City>San Jose</City>
      <Postcode>10701</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>srojas33@gmail.com</Email>
    <Phone>
      <Home>83803788</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Galina Deeva</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4380989503895589</CreditcardNumber>
      <NameonCreditcard>Sebastian  Rojas G</NameonCreditcard>
      <CreditcardExpirationMonth>8</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2024</CreditcardExpirationYear>
      <CreditcardAmount>23.25</CreditcardAmount>
      <CreditcardCodeNumber>373</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
bb004780
ARS-02-0029438
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0029438</PolicyNumber><UserName>bb004780</UserName><Password>bb004780</Password></PolicyDetails></RegistrationRes>