174.129.122.238
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>01/11/2017</StartDate>
  <EndDate>03/08/2017</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Lucas</Firstname>
    <Middlename/>
    <Lastname>Ravanello Mokwa</Lastname>
    <Age>21</Age>
    <Dob>08/09/1995</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>01/11/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>Rua Barão do Rio Branco 347</Address1>
      <Address2>apt 604</Address2>
      <Country>Brazil</Country>
      <State/>
      <City>Bento Goncalves</City>
      <Postcode>95700168</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>lucasravam@gmail.com</Email>
    <Phone>
      <Home>5484386191</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Noilve Ravanello Mokwa</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Mother</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4415241609605275</CreditcardNumber>
      <NameonCreditcard>Lucas R Mokwa</NameonCreditcard>
      <CreditcardExpirationMonth>1</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2017</CreditcardExpirationYear>
      <CreditcardAmount>70.68</CreditcardAmount>
      <CreditcardCodeNumber>510</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
2dbc25e8
ARS-02-0029469
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0029469</PolicyNumber><UserName>2dbc25e8</UserName><Password>2dbc25e8</Password></PolicyDetails></RegistrationRes>