184.72.211.106
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>0</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>10/04/2016</StartDate>
  <EndDate>11/29/2016</EndDate>
  <DestinationPlan>Colombia</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Adam</Firstname>
    <Middlename>J</Middlename>
    <Lastname>DeBoer</Lastname>
    <Age>39</Age>
    <Dob>08/18/1977</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>10/04/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>875 University Ave E</Address1>
      <Address2>#40</Address2>
      <Country>Canada</Country>
      <State>Ontario</State>
      <City>Waterloo</City>
      <Postcode>N2K0A1</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>ajdeboer@yahoo.ca</Email>
    <Phone>
      <Home>2369993350</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Dianne Trussler</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Mother</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Mastercard</CreditcardType>
      <CreditcardNumber>5175370000371398</CreditcardNumber>
      <NameonCreditcard>Adam J DeBoer</NameonCreditcard>
      <CreditcardExpirationMonth>7</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>64.13</CreditcardAmount>
      <CreditcardCodeNumber>142</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
a32744d9
ARS-01-0029872
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0029872</PolicyNumber><UserName>a32744d9</UserName><Password>a32744d9</Password></PolicyDetails></RegistrationRes>