52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>50000</MaximumLimit>
  <StartDate>12/14/2016</StartDate>
  <EndDate>04/19/2017</EndDate>
  <DestinationPlan>Mexico</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Deni</Firstname>
    <Middlename>L</Middlename>
    <Lastname>Ida</Lastname>
    <Age>76</Age>
    <Dob>01/03/1940</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>12/14/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>#15  9970 Wilson Street</Address1>
      <Address2/>
      <Country>Canada</Country>
      <State>British Columbia</State>
      <City>Mission</City>
      <Postcode>V4S 1B3</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>deniida@yahoo.com</Email>
    <Phone>
      <Home>7786539454</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Lauri Jane Wiens</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Daughter</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4537034564127036</CreditcardNumber>
      <NameonCreditcard>Deni Ida</NameonCreditcard>
      <CreditcardExpirationMonth>6</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2017</CreditcardExpirationYear>
      <CreditcardAmount>730.25</CreditcardAmount>
      <CreditcardCodeNumber>364</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
10709e83
ARS-01-0030463
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0030463</PolicyNumber><UserName>10709e83</UserName><Password>10709e83</Password></PolicyDetails></RegistrationRes>