52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>1000</DeductibleAmount>
  <MaximumLimit>110000</MaximumLimit>
  <StartDate>11/01/2017</StartDate>
  <EndDate>10/31/2018</EndDate>
  <DestinationPlan>Thailand</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>David</Firstname>
    <Middlename>R</Middlename>
    <Lastname>Bailey</Lastname>
    <Age>57</Age>
    <Dob>02/15/1960</Dob>
    <Gender>Male</Gender>
    <SportsRider>yes</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>11/01/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>1600 Eldridge Parkway Apt 3005</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>Texas</State>
      <City>houston</City>
      <Postcode>77077</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>drby01@gmail.com</Email>
    <Phone>
      <Home>8328786977</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Helen Bailey-Betts</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Mother</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147202193628128</CreditcardNumber>
      <NameonCreditcard>David R Bailey</NameonCreditcard>
      <CreditcardExpirationMonth>9</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2018</CreditcardExpirationYear>
      <CreditcardAmount>1146.39</CreditcardAmount>
      <CreditcardCodeNumber>758</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
e7c9bf22
ARS-01-0037591
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0037591</PolicyNumber><UserName>e7c9bf22</UserName><Password>e7c9bf22</Password></PolicyDetails></RegistrationRes>