52.45.148.122
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>250</DeductibleAmount>
  <MaximumLimit>50000</MaximumLimit>
  <StartDate>12/21/2016</StartDate>
  <EndDate>12/31/2016</EndDate>
  <DestinationPlan>United States</DestinationPlan>
  <NoOfApplicants>2</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>jacob</Firstname>
    <Middlename/>
    <Lastname>assif</Lastname>
    <Age>72</Age>
    <Dob>11/24/1943</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
  <Applicant>
    <Firstname>liliane</Firstname>
    <Middlename/>
    <Lastname>assif</Lastname>
    <Age>70</Age>
    <Dob>08/02/1946</Dob>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>12/21/2016</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>662 sheppard ave. east LPH03</Address1>
      <Address2>LPH03</Address2>
      <Country>Canada</Country>
      <State>Ontario</State>
      <City>toronto</City>
      <Postcode>m2k 3e6</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>yacovassif@gmail.com</Email>
    <Phone>
      <Home>6474387500</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName>jacob assif</AdDBeneficiaryName>
    <AdDBeneficiaryRelationship>Other</AdDBeneficiaryRelationship>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4520883005793361</CreditcardNumber>
      <NameonCreditcard>jacob  assif</NameonCreditcard>
      <CreditcardExpirationMonth>11</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2018</CreditcardExpirationYear>
      <CreditcardAmount>158.4</CreditcardAmount>
      <CreditcardCodeNumber>831</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
bdcf497a
a6a0061a
ARS-02-0030528
ARS-02-0030529
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0030528</PolicyNumber><UserName>bdcf497a</UserName><Password>bdcf497a</Password></PolicyDetails><PolicyDetails><PolicyNumber>ARS-02-0030529</PolicyNumber><UserName>a6a0061a</UserName><Password>a6a0061a</Password></PolicyDetails></RegistrationRes>