52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>1</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>11/08/2017</StartDate>
  <EndDate>11/13/2017</EndDate>
  <DestinationPlan>Brazil</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>Vincent</Firstname>
    <Middlename>S</Middlename>
    <Lastname>Flores</Lastname>
    <Age>30</Age>
    <Dob>04/24/1987</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>11/08/2017</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>278 Mott St</Address1>
      <Address2>Apt 5C</Address2>
      <Country>United States</Country>
      <State>New York</State>
      <City>New York</City>
      <Postcode>10012</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>vincent.s.flores@gmail.com</Email>
    <Phone>
      <Home>3479824293</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>Samantha Huncharek</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Spouse</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147202270377268</CreditcardNumber>
      <NameonCreditcard>Vincent  Flores</NameonCreditcard>
      <CreditcardExpirationMonth>8</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>5.4</CreditcardAmount>
      <CreditcardCodeNumber>112</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
b73e4f19
ARS-01-0037767
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-01-0037767</PolicyNumber><UserName>b73e4f19</UserName><Password>b73e4f19</Password></PolicyDetails></RegistrationRes>