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>09/22/2016</StartDate>
  <EndDate>09/25/2016</EndDate>
  <DestinationPlan>Canada</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Sheri</Firstname>
    <Middlename/>
    <Lastname>Emery</Lastname>
    <Age>49</Age>
    <Dob>03/08/1967</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>09/22/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>16052 Maplewild Ave SW</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>Washington</State>
      <City>Burien</City>
      <Postcode>98166</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>mbemery67@icloud.com</Email>
    <Phone>
      <Home>2064120084</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Mark Emery</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4226950003206550</CreditcardNumber>
      <NameonCreditcard>Mark Emery</NameonCreditcard>
      <CreditcardExpirationMonth>12</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2018</CreditcardExpirationYear>
      <CreditcardAmount>12.25</CreditcardAmount>
      <CreditcardCodeNumber>818</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
40bb1593
ARS-02-0029690
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0029690</PolicyNumber><UserName>40bb1593</UserName><Password>40bb1593</Password></PolicyDetails></RegistrationRes>