184.72.211.106
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>110000</MaximumLimit>
  <StartDate>11/13/2016</StartDate>
  <EndDate>05/28/2017</EndDate>
  <DestinationPlan>Chile</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Justin</Firstname>
    <Middlename>E</Middlename>
    <Lastname>Dollimont</Lastname>
    <Age>39</Age>
    <Dob>09/07/1977</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>11/13/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>248A Grosbeak Way </Address1>
      <Address2>Unit 103</Address2>
      <Country>Canada</Country>
      <State>Alberta</State>
      <City>Fort McMurray</City>
      <Postcode>T9K 0V8</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>justindollimont@gmail.com</Email>
    <Phone>
      <Home>7807887052</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Heidi Gould</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Significant other</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4520885005934887</CreditcardNumber>
      <NameonCreditcard>Justin  Dollimont</NameonCreditcard>
      <CreditcardExpirationMonth>3</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2017</CreditcardExpirationYear>
      <CreditcardAmount>212.76</CreditcardAmount>
      <CreditcardCodeNumber>881</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
bbe8229e
ARS-01-0029715
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0029715</PolicyNumber><UserName>bbe8229e</UserName><Password>bbe8229e</Password></PolicyDetails></RegistrationRes>