52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>1100000</MaximumLimit>
  <StartDate>09/09/2018</StartDate>
  <EndDate>09/16/2018</EndDate>
  <DestinationPlan>Iceland</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>James</Firstname>
    <Middlename>R</Middlename>
    <Lastname>Goryl</Lastname>
    <Age>44</Age>
    <Dob>12/14/1973</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>09/09/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>316 W Burlington Ave</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>Illinois</State>
      <City>Westomt</City>
      <Postcode>60559</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>jgregistration@yahoo.com</Email>
    <Phone>
      <Home>4356029144</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Angela Parenti (SLC Utah)</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Friend</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147202286405160</CreditcardNumber>
      <NameonCreditcard>James R Goryl</NameonCreditcard>
      <CreditcardExpirationMonth>12</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>16.0</CreditcardAmount>
      <CreditcardCodeNumber>750</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
767af97a
701823658

<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>701823658</PolicyNumber><UserName>767af97a</UserName><Password>767af97a</Password></PolicyDetails></RegistrationRes>