52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>110000</MaximumLimit>
  <StartDate>09/24/2018</StartDate>
  <EndDate>10/06/2018</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Timothy</Firstname>
    <Middlename>J</Middlename>
    <Lastname>Burgess</Lastname>
    <Age>55</Age>
    <Dob>06/03/1963</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>09/24/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>2-29-4-903 Shiohama</Address1>
      <Address2/>
      <Country>Japan</Country>
      <State/>
      <City>Koto-ku Tokyo</City>
      <Postcode>135-0043</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>info@ontica.com</Email>
    <Phone>
      <Home>817028202563</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4659014606622014</CreditcardNumber>
      <NameonCreditcard>VL Barker</NameonCreditcard>
      <CreditcardExpirationMonth>7</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2020</CreditcardExpirationYear>
      <CreditcardAmount>59.54</CreditcardAmount>
      <CreditcardCodeNumber>510</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
7b27dde6
701817275

<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>701817275</PolicyNumber><UserName>7b27dde6</UserName><Password>7b27dde6</Password></PolicyDetails></RegistrationRes>